Hospital Pricing and Charges
Healthcare pricing and charges can be complex. Coffey Health System is committed to helping our patients and their family members understand their healthcare charges.
When determining the cost of a healthcare service, you must first understand that each situation is different. What a patient owes for a hospital procedure or service can vary greatly, depending on health insurance coverage, eligibility for state or federal programs, and each individual's own personal situation.
Here are some important considerations:
“Charge” is not the same as what you may owe. “Charge” is the amount billed for a service.
Professional charges (surgeons, radiologists, anesthesiologists, pathologists, emergency room physician, etc.) may be billed separately. These charges may not be included in the average charges shown.
Because each person’s health needs are different, the average charges shown will depend on the individual’s specific situation. In our examples below, we have shown the upper and lower charge range for common procedures listed. The majority of procedures will fall into this range.
If you have health insurance, your insurance will pay for many of your services but not all. It’s important to first contact your insurance company to understand your deductible, co-pay, coinsurance, and out-of-pocket levels. To avoid out-of-network penalties, confirm whether you are required to use healthcare facilities that are in your network. In addition, ask if you need to obtain pre-certification or referral approvals prior to your hospital service. This will help you avoid penalties and additional amounts owed if the required approval is not obtained. Some insurance companies negotiate discounts with hospitals on behalf of the patients they insure. These discounts vary among insurance companies.
If you have Medicare, Medicare will pay for many of your health services but not all. Your Medicare deductibles and coinsurance are pre-established.
If you have a Medicare supplemental insurance policy, it might pay all or a portion of your Medicare deductibles and coinsurance. Special rules apply if you or your spouse have health insurance coverage through your employer. Special rules also apply if you have coverage through a Medicare Managed Care plan. Contact your Medicare Managed Care plan to understand your deductible, co-payment, coinsurance, and maximum out-of-pocket levels. To avoid out-of-network penalties, check to see if you are required to use healthcare facilities that are in the Medicare Managed Care Plan’s network. To contact Medicare, visit http://www.medicare.gov/.
If you have Medicaid or a Medicaid Managed Care Plan, Medicaid will pay for many (but not all) of your health services. A few services have minimal pre-established co-pays that are your responsibility. Co-pays will not apply if you are in a Medicaid Managed Care Plan.
If you are uninsured and have a financial need, assistance is available that can lessen the burden of healthcare facility. To determine eligibility, you will be asked to provide income and asset information. To learn more, please call our finance department at (620) 364-2121 or click here.
We understand that this is a complex system. To help you make the best possible decisions regarding your healthcare, we have representatives who are trained to assist you with determining an estimate of your services.
Please call our business office at (620) 364-2121 Ext. 5308, Monday through Friday, 8 a.m. to 4:30 p.m. for a good faith healthcare charge estimate. To help us prepare your good faith estimate, please obtain procedure codes or CPT codes from your ordering physician.
If you have health insurance, we will likely be able to provide an estimate of your out-of-pocket responsibility. Availability of this service is dependent on your insurance company’s ability to provide us with up-to-date benefit information prior to your service. For the most accurate information, it is always best to check with your insurance company regarding your coverage. For your convenience, a list of Kansas Insurance Company phone numbers and websites is available here[j2].
Before reviewing the link below, please understand that:
1) Prices listed between $0 and $5 may indicate that the actual charges will be determined at the time of service.
2) Pharmacy prices can be volatile and can change frequently throughout the year. Prices listed here are a snapshot of prices at the time of posting and can vary from what you are billed.
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