Pricing Transparency
To improve price transparency, all U.S. hospitals are required to provide information about the rates negotiated with insurance companies for all services and items offered. Each hospital is required to make this information available in two ways: 1) as a comprehensive machine-readable file with all items and services; and 2) a display of shoppable services in a consumer-friendly format.
Standard Charges
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For purposes of complying with the Hospital Price Transparency Final Rule, the Standard Charges file includes:
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Gross charge- the charge for an individual item or service that is reflected on a hospital’s chargemaster, absent any discounts
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Discounted cash price- the charge that applies to an individual who pays cash, or cash equivalent, for a hospital service
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Payer-specific negotiated charge- the charge that a hospital has negotiated with a third party payer for an item or service
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De-identified minimum negotiated charge- the lowest charge that a hospital has negotiated with all third-party payers
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De-identified maximum negotiated charge- the highest charge that a hospital has negotiated with all third-party payers
The Standard Charges pricing list below reflects data in the hospital’s chargemaster. Actual charges will vary based on medical need at the time services are rendered. Fees for physician services are not reflected in our standard charges pricing list and will be billed separately by your physician.
Managed care payers/plans pay inpatient rehabilitation hospitals based on an overall rehabilitation service category, also referred to as a “service package” by Medicare. A typical inpatient rehabilitation service category will include: room and board, all related therapy services, routine supplies, routine medications, and all nursing services.
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Other services may be required and may be paid in addition to the services listed above. These services may be billed by a different provider than the hospital and sent to you on a separate bill. Examples of these additional services may include but are not limited to special equipment, high cost pharmacy items, dialysis treatments, and high cost diagnostic services such as a CT scan or MRI.
Shoppable Services
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Medicare defines shoppable services as a service that can be scheduled by a health care consumer in advance on a non-urgent basis. Medicare has identified 70 shoppable services that all hospitals must include and Medicare has asked hospitals to each choose at least 230 additional shoppable services that they perform most frequently. If a particular service is not offered by our Hospital, an “NA” will be displayed. We have listed the most common services or service packages we provide with the corresponding negotiated charges paid by the managed care plans in the shoppable Services file.
Please contact us at 414-441-0500 for more information about the Hospital’s pricing. Our team is happy to assist you in understanding your costs or to obtain a price estimation. Patients and prospective patients have the right to request a personalized estimate from the hospital.
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Last updated- July, 2024