Price Transparency

Price transparency is very important and consumers deserve to understand, in advance, what their healthcare will cost. Clinch Memorial Hospital has established a price estimator tool that will provide you with the cost associated with 300 standard procedures at Clinch Memorial Hospital. To use this tool you will need your insurance member information.

Price Estimator

The estimation provided is not a guarantee of your costs or benefits. Your actual costs may vary based on several factors. This is a hospital estimate only and does not include any physician charges.

 

To make the process more transparent, we are happy to follow CMS (Centers for Medicaid and Medicare Services) guidelines that require all hospitals to make available a list of standard charges (sometimes called a Chargemaster List) for products and services provided at the facility.

Before reading the list, please note that:

  • The Chargemaster List does not generally reflect what a patient or insurer pays and not what the hospital receives in payment.
  • The charges included in the Chargemaster List do not reflect any discounts negotiated by insurance providers or other payment discounts that can greatly reduce the prices.
  • What a patient will actually pay (or a patient’s responsibility) may vary depending on his/her individual health insurance plan, deductible amounts and co-pays.

Uninsured or under-insured patients should always consult with our staff to determine if they qualify for discounts. Our financial counselors welcome questions and are available to provide assistance. Contact the Patient Financial Services department at the hospital during regular business hours at 912-470-2532.

The prices included in the price list are correct as of November 18, 2021.

Click here to download a machine readable file that contains all charges and negotiated rates with payors for Clinch Memorial Hospital.

 

What is a charge?

A hospital charge is a federally-required maximum “list price” for an item or service that does not reflect any negotiated discount by the insurance provider.  Hospitals are required to maintain a catalog of procedures, descriptions and list prices in a complex accounting tool, known as the hospital Chargemaster.

 

What do health insurance providers pay?

Insurers (including Medicare, Medicaid, commercial health insurance providers, and others) do not pay the charges listed in the Chargemaster List. Instead, they pay a set price that is negotiated in advance. Every insurance company pays the hospital differently based on their contract. Patients pay only the out-of-pocket amounts set by their insurance providers.

 

How can I use this hospital charge information for comparing prices?

Charge information, by itself, isn’t generally useful to determine how much patients may need to pay, or to compare what a patient might owe a hospital. Discounts and fee schedules are used to determine how much insurance providers pay and may vary from hospital to hospital.

 

How are charges different from what insurance companies pay?

Again, Medicare, Medicaid and commercial insurance providers negotiate set prices for what they will pay for medical services. In most cases, what your insurance company sets as the reimbursement will be less than the hospital Chargemaster. For example, the charge for staying in a hospital room for one day may be listed in the Chargemaster as $1,500, but the negotiated fee agreed upon by the insurance provider may only be $700.

 

How are charges different from your possible out of pocket costs, like your deductible or co-insurance?

Deductibles and co-pay amounts are based on the reimbursement terms set by your insurance provider for covered services.  They are rarely ever based on the actual hospital Chargemaster.

 

How are charges different from your possible out of pocket costs, like your deductible or co-insurance?

Deductibles and co-pay amounts are based on the reimbursement terms set by your insurance provider for covered services.  They are rarely ever based on the actual hospital Chargemaster.