SwedishAmerican Hospital is committed to continuously improving price transparency by posting a list of charges for inpatient and outpatient services; this is known as charge master.
Prices listed in charge master are an average, with the actual cost dependent on individual details; therefore, making it difficult to determine your exact obligation or compare prices at different hospitals or health care service providers. For more information about charges for your care and to obtain an estimate, please contact our Patient Financial Services staff at 779-696-7150.
Important to Note:
- Federal law requires hospitals set uniform charges (the amount set before any discount) as the starting point for all bills.
- The starting list of charges is the same for every patient; however, charges may vary by patient even though a similar procedure was performed. This may be due to the patient’s medical condition, length of time spent in surgery or recovery, complications requiring unanticipated procedures, kinds of medication needed, etc.
- Illinois hospitals are not paid these charges by patients or health plans.
- Posting the charge master (a list of possibly 10,000+ codes with a corresponding charge) will not be useful for a patient to know how much they will pay.
- Posting Charge Master (a list of over 10,000 codes with a corresponding charge) is only an estimate of what the patient will pay.
What does the health plan pay?
- Commercial insurers (Blue Cross, United Health Care, etc.) negotiate discounts with hospitals on behalf of their members, and pay hospitals at varying discount levels, much less than starting charges. Medicare and Medicaid pay according to a regulated fee schedule - both pay at much less than what it costs the hospital to provide the service
- Medicare and Medicaid pay hospitals based on pre-set rates varying among individual hospitals. These rates reflect different hospitals costs of providing care, such as trauma, teaching programs, severity of illness and area wages, among other things.
So How Much Will a Patient Pay?
- Patients with health coverage will only pay the deductible, coinsurance or copay required by their health plan. Although hospitals can assist with estimated charge information for the service being sought, the health plan is the best source of information pertaining to what an insured patient will pay.
- Uninsured patients can apply for Financial Assistance Program, which can be applied for by calling Patient Financial Services at 779-696-7150.
- The Illinois’ Hospital Report Card website lists the average charge for over 50 services at individual hospitals for specific services.