CMS Hospital Pricing
The Centers for Medicare and Medicaid Services (CMS) as part of the 2019 IPPS Final Rule requires hospitals to make available online a listing of standard charges called a chargemaster. Clinch Memorial Hospital supports educating patients on the cost of health care and the patient financial responsibilities.
Understanding Hospital Charge Information
The amount a hospital bills for a patient’s care is known as the “charge.” This is not the same as the actual cost or amount paid for the care. The amount collected by a hospital for each service is almost always less than the amount billed.
Because each case is different based on the patient’s medical condition, one patient’s charge amount may not necessarily be the same as another patient’s. If two patients have the same service or procedure but one is healthy, and one has a chronic illness, it is likely that the patient with the chronic illness would need more intensive care thus creating a bill with higher charges than the healthy patient’s bill. The total charges of a service or a procedure will also vary based on the combination of services provided including hospital fees, physician fees, drugs, supplies, lab tests or radiology procedures. In addition, a patient may receive a hospital facility charge and/or a professional charge.
The amount a patient is responsible for also depends on insurance coverage. Clinch Memorial negotiates discounted rates with insurance companies and those patients whose insurance is in network with our hospital will be responsible for a lower amount than those with out-of-network coverage or no insurance. Patients with no insurance or those in financial need may receive discounted rates based on their income. Our Financial Counselor can help to determine those discounts. To view our Financial Assistance Policy, click here.
If the services received are covered by insurance, the benefits will determine how much will be required to be paid out of pocket. Clinch Memorial can provide out of pocket estimates for services to be performed based on your insurance plan. Please contact the Revenue Cycle Director within Patient Financial Services for assistance at 912-487-5211, extension 4530 or email your request to firstname.lastname@example.org. The following information is required when requesting an estimate for services:
- Description of services – you will need to provide a description of the medical service you are seeking or the CPT procedure code, which can be obtained from your attending or referring physician
- Name of your insurance
- Type of insurance, for example, PPO, HMO, POS, Medicare, Medicaid, self-pay
A hospital chargemaster is a list of all billable services charged by the hospital for services rendered. A full copy of Clinch Memorial Hospital’s chargemaster is available by clicking on the following link.
**Please Note: Prices are subject to change, charges are NOT reflective of final patient costs, and actual services delivered may differ from those anticipated.