Transparency of Hospital Charges

Transparency of Hospital Charges

Requests to View Hospital Standard Charges:

The Requirement for Transparency of Hospital Charges Rule is intended to assist patients in understanding their potential financial liability for services obtained at our hospital and to allow comparison for similar services across hospitals. However, hospital charge masters are lengthy and complex documents which do not provide information at a level that is easy to understand for this purpose. Requesting a pricing estimate for specific services that a patient is seeking to have performed at the hospital is the recommended choice for patients to gain a better understanding of their financial responsibility. You may contact the Hospital's Financial Counselor at 618-498-8326 to inquire about price estimates.

We have also provided the additional information below to aid in understanding of hospital charges.

HFMA's Understanding Healthcare Prices: A Consumer Guide:

The nationally based Healthcare Financial Management Association (HFMA) developed the HFMA's Understanding Healthcare Prices: "A Consumer Guide" to aid patient understanding of hospital charges. A copy of this guide is provided on the Hospital's website at https://www.hfma.org/consumerguide

Definitions:

Hospital charges are the amounts set before any discounts. Hospitals are required by the federal government to utilize uniform charges as the starting point for all bills. Charges are based on what type of care was provided and can differ from patient to patient for the same service depending on any complications or different treatment provided due to the patient's health. Therefore, actual charges for a specific patient will differ from the listed standard charges.

These charges represent the standard charges for procedures and diagnosis-related groups. The charge is for care without complications. Actual charges may be different for specific patients due to medical condition, length of time spent in surgery or recovery, necessary specific equipment, supplies or medication, complications requiring unanticipated procedures or other treatment ordered by the physician.

Discounts & Financial Assistance:

Many patients seeking hospital charge information are interested in knowing what their out-of-pocket financial responsibility will be. This is an opportunity to have important conversations regarding payment options.

If a patient has health insurance, significant discounts have already been obtained by the insurance company and the patient only needs to pay the deductible, copay and/or coinsurance. Patients should contact their health plan directly for their specific financial obligations that aren't reimbursed by insurance.

Patients who are uninsured or under insured may pre-purchase certain heathcare service through www.MDSave.com at a greatly reduced rate. Services purchased through MDSave are done on a self-pay basis only and Jersey Community Hospital will not submit any bills to your insurance carrier for these services.

Jersey Community Hospital has a financial need assistance program whereby uninsured and insured patients may qualify for discounted services based on household income as compared to the Federal Poverty Level. Those without health insurance may also qualify for discounts under the Illinois Hospital Uninsured Patient Discount Act and any other discounts. Please visit the Patient Financial Assistance section of the hospital website at www.jch.org or inquire about the financial need assistance program and Illinois Hospital Uninsured Patient Discounts with the Hospital's Patient Financial Counselor for further assistance.

Price Estimates:

Requests for price estimates should be directed to the Hospital's Patient Financial Counselor at 618-498-8326.

Price estimates are not a quote or a guarantee of what the charges will be for a specific patient's care. This charge information generally does not include the professional services provided by a physician, surgeon, radiologist, anesthesiologist/certified registered nurse anesthetist, pathologist, advanced practice nurse, physician assistant or other practitioners.

Patients will receive separate bills for the physicians and other professionals who provided treatment. These physicians may not be participating providers in the same insurance plans and networks as the hospital. As such, there may be greater patient financial responsibility for these services which are not under contract with the health plan.

Quality Care:

An important component for choosing a health care provider is determining quality of care. Your doctor can be a helpful resource in choosing where to obtain care. Further Medicare hospital-specific quality outcome measures are located on the Hospital Compare website at www.medicare.gov/hospitalcompare. To compare hospital median charges for nearly 50 major diagnoses, quality and patient satisfaction metrics in Illinois, go to the Illinois Hospital Report Card website at www.healthcarereportcard.illinois.gov.

Hospital Charges:

An important component for choosing a health care provider is determining quality of care. Your doctor can be a helpful resource in choosing where to obtain care. Further Medicare hospital-specific quality outcome measures are located on the Hospital Compare website at www.medicare.gov/hospitalcompare.