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What is Price Transparency?

People deserve meaningful information about the price of their hospital care. Price transparency is an effort to make the necessary information available and easy to understand to help consumers compare provider costs and anticipate their own expenses. Newberry Hospital is committed to sharing information that will help you make important decisions about your health care plans.  Please contact our facility at 803.405.7135 for information about your bill or for an estimate of care that you may require, based on the specific services ordered by your doctor.

 

What we charge

We have provided a complete list of our hospital chargemaster which includes charges for all items and services provided by our facility.  Providing meaningful information to our patients about their healthcare costs has long been a goal of our hospital.  For several years, we have participated in the South Carolina Hospital Association’s PricePoint program which lists hospital charges for inpatient, outpatient and emergency department services.  This report provides the public average charges by hospital that best compares to the amounts on the bill you will receive from us.  This program also allows users the opportunity to compare our hospital prices side-by-side with others in the state. Click here for an introduction to the program and an estimation of care you may be considering.

 

How do I estimate the amount that I will be required to pay?

Unfortunately, understanding what you will have to pay for healthcare services is very complicated. Unlike most bills you receive, it is very difficult for you to determine exactly what you will have to pay for an item or service.  It is even hard for your hospital to estimate prior to your care what you may be billed as every patient’s care is different and determined after you are admitted.  To further complicate matters, we are most often not aware of the agreement you have with your insurer. This agreement of coverage defines your personal out-of-pocket responsibility.

The amount of money you will be responsible for personally is generally determined by your insurance coverage or managed care company, not by the hospital.  These amounts are determined directly by your contract with your insurer.  Also, all doctors, hospitals or services may not be covered by your plan. Unfortunately, we do not have this information available to us before you receive care from our hospital.  The best source of information about what you will have to pay will come from your insurance company as they are already aware of what services are covered and who they will pay to deliver the care, and the amount they will hold you responsible for.

Medicare and Medicaid pay hospitals according to a set fee schedule. It represents a discount from a hospital’s billed charges. Numerous factors, such as co-insurance and deductibles affect your own financial responsibility.  A summary of Medicare patient payment requirements is provided at Medicare.gov

If you have no insurance coverage at all, our hospital provides discounts and needs-based payment assistance.  You can review our policies and complete an application at www.NewberryHospital.org.  Our staff is here to help you determine the assistance you may qualify for and to help make affordable payments of the balances that you will be responsible for.

Newberry Hospital wants to provide the care that you need, when you need it, delivered at the highest quality possible, at the most affordable price possible.

 

Surprise Billing

During your stay, you may receive services from individuals or companies not employed or owned by our hospital.  As an example, statute requires that a licensed radiologist review your radiology exams and advise your physician of their findings.  These radiologists are often not employed by our facility; therefore, you will receive a bill directly from their office for their services and these charges will not be included in your bill from our hospitals.  Even if our hospital is in your insurer’s network, it is possible that individual doctors or other providers are out-of-network. Each of these provider’s contract with insurance companies directly, apart from our hospital’s contracts.  Because of this, it is possible that your insurance discounts will not apply to their charges.  Our hospital is not aware of these private contracts between the physician and your insurance company. Your insurance carrier can also inform you of which providers are in-network on your plan and will be able to provide estimations of their coverage for these services.

It is our goal to make you aware of any charges that will be billed to you separately by other providers.  If your doctor orders items such as radiology testing, lab testing, physical therapy or any service that may require a specifically trained individual to perform, feel free to ask our staff for assistance in determining what it will cost.

 

Suggested Reading:

A Charge Master FAQ that describes what the chargemaster is and is not.

A consumer guide to health care prices prepared by the Healthcare Financial Management Association.

Medicare Frequently Asked Questions prepared by CMS as their source of further definition of the requirements.

The Final Rule 2019 CMS IPPS Final Rule contains the actual final ruling that dictates the release of chargemaster data.

A summary of the rule and related CMS guidance.

A consumer guide to avoiding surprise medical bills jointly prepared by the American Hospital Association, Healthcare Financial Management Association and America’s Health Insurance Plans.

 

Disclaimer

The information on this page is intended to meet the requirements of The Centers for Medicare & Medicaid Services final inpatient prospective payment system, or IPPS, rule (see pages 2135-2142) for federal fiscal year 2019. The IPPS rule contains a transparency provision that will be effective Jan. 1, 2019.  The prices included on this website may not reflect the most current charge items or charge amounts of this facility as additions and changes are frequently made to the listing.  Therefore, these charges may not be representative of the charges you will receive on your bill for services provided by our facility.  CMS requires that hospitals update the charge transparency data at least annually.  This data was last updated December 2018.

The detailed chargemaster information on this site is intended only to meet federal requirements and for informational purposes only and should not be used solely when making healthcare decisions.

The information on this page contains only charges on Newberry Hospital’s chargemaster and may not include all related charges for physician office fees, clinic charges, radiologists, pathologists and other services provided in conjunction with our hospital services.