Hospital Charge Information List

Transcription

1 Hospital Charge Information List To better inform our patients, Norton Healthcare has prepared the following price list of our charges for some of the more common reasons for a hospital visit. They include use of the emergency department, operating room rates, child birth, physical therapy and other procedures. The hospital's charges are the same for all patients, but the final charges to each patient may vary depending on the agreements Norton Healthcare has negotiated with individual health insurers. As a not-for-profit health care provider, Norton Healthcare returned more than $156 million in community benefit to the Louisville metro area in 2013, consisting primarily of charity care and unreimbursed Medicare costs. In addition, Norton Healthcare offers substantial discounts to patients who do not have healthcare coverage. Those with questions regarding their potential costs for care or payment options can call (502) to consult with one of our billing advisors. For those patients who have health care coverage, Norton Healthcare can also provide you with an estimate of your out of pocket portion of the bill. All questions can be directed to the Managed Care Department at (502) BILLING POLICIES Norton Healthcare wants to ensure that patients receive the full benefits of their insurance coverage as well as consideration under our discount programs. Before we bill you, we will bill your insurance provider, including Medicare and Medicaid, and any secondary insurance providers. We do not charge interest on any balance due after insurance payments are received. In addition to your hospital bill, you may receive a separate bill for physician or other professional service providers involved in your hospital care. If you are not able to pay the amount you owe in full, you may contact Customer Service at regarding applying for financial assistance or being set up on a payment plan. Emergency service will never be delayed or withheld on the basis of a patient s ability to pay. The following prices are in effect as of 04/01/17. INPATIENT PER DAY ROOM RATES The following charges do not include fees for drugs, supplies or additional procedures that may be required for a particular inpatient stay. They also do not include fees for physicians who will bill separately for their services. Routine Care Private Room $ Routine Care, Semi-Private $ Psychiatric $ Intensive Care Unit $ Neonatal Intensive Care $ Nursery $

2 EMERGENCY SERVICES Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with Level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians who will bill separately for their services. Level 1 $ Level 2 $ Level 3 $ Level 4 $ Level 5 $ Critical Care, Init.Care $ Critical Care, Additional 30 Minutes $ OPERATING ROOM Operating Room charges are based on the intensity level with Level 1 being the most basic for a particular operation. The following charges do not include fees for anesthesia, recovery, drugs, supplies or additional ancillary procedures that may be required. They also do not include professional fees for surgeons, physicians or anesthesiologists who will bill separately for their services. The below charges are for the Norton Healthcare. Level 1 Per Minute $ Level 2 Per Minute $ Level 3 Per Minute $ Level 4 Per Minute $ Level 5 Per Minute $ Level 6 Per Minute $ Level 7 Per Minute $ Level 8 Per Minute $ Level 9 Per Minute $ Level 10 Per Minute $ Level 11 Per Minute $ DELIVERY ROOM The following list does not include charges for anesthesia, recovery, drugs or supplies required for a particular delivery room procedure. They also do not include professional fees for physicians or anesthesiologists who will bill separately for their services. Vaginal Delivery w or w/o Episiotomy $ Cesarean Section Delivery (1 HR of OR time) $ Fetal Non-Stress Test $ Ultrasound Pregnant Uterus Limited $

3 LABORATORY The following charges represent the Hospital s most common laboratory procedures. Allergen Specific Ige $ Basic Metabolic Panel $ Blood Culture, Bacteria $ Blood Gases $ Blood Glucose $ Blood Typing, ABO $ Blood Typing, Rh $ Compatibility Test, Spin $ Complete Blood Count $ Complete Blood Count/Diff $ Creatine Kinase Total (CPK) $ Creatine, MB Fraction $ Full Lipid Panel $ Hemoglobin $ Hepatic Function Panel $ Infect Agent Smear $ Magnesium Blood $ Phosphorus $ Prothrombin Time $ RBC Antibody Screen $ Thromboplastin Time, Partial $ Thyroid Stimulating Hormone $ Troponin $ Urinalysis, Microscopic $ Urine Creatinine $ Urine Culture $ Urine Pregnancy Test $ RADIOLOGY The following charges represent the Hospital s 30 most common x-ray and radiological procedures. They also do not include fees for physicians who will bill separately for their services. X-Ray Wrist, Complete $ X-Ray Shoulder, Complete $ X-Ray Pelvis, 1 or 2 Views $ X-Ray Lower Spine, 2 or 3 Views $ X-Ray Lower Leg, 2 Views $ X-Ray Knee, 1 or 2 Views $ X-Ray Hip Unilateral, Complete $ X-Ray Hand, Minimum 3 Views $ X-Ray Foot, Minimum 3 Views $ X-Ray Chest, Single View $ X-Ray Chest, 2-View $ X-Ray Ankle, Complete $ X-Ray Abdomen, Single View $ Ultrasound Pelvis, Complete $ Ultrasound OB Limited $ Ultrasound OB >14 Wks $

4 Ultrasound Non-OB Transvag $ Ultrasound Breast(s) $ Ultrasound Abd, Limited $ Mammogram Screening Bilat $ Mammogram Diagnostic Unilateral $ Mammogram Diagnostic Bilateral $ Fluoroscopy, < 1 Hour $ Fluoroscopy for Needle Placement $ CT Chest w/ Contrast $ CT Pelvis w/ Contrast $ CT Neck w/o Contrast $ CT Head w/o Contrast $ CT Abdomen w/ Contrast $ Computer Aided Det. w/ Screening $ PHYSICAL THERAPY The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges depending on the services performed. PT Therapeutic Exercise per 15 min $ PT Manual Therapy per 15 min $ PT Functional Activity per 15 min $ PT Evaluation $ PT Neuromuscular Reeducation per 15 min $ OCCUPATIONAL THERAPY CHARGES The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges depending on the services performed. OT Therapeutic Exercise per 15 min $ OT Therapeutic Activity per 15 min $ OT Manual Therapy per 15 min $ OT Cognitive Rehabilitation $ OT Initial Evaluation $ OT Neuromuscular Reeducation per 15 min $ OT Activities Daily Living Training $ RESPIRATORY THERAPY AND PULMONARY FUNCTION CHARGES The following charges reflect the most common services offered by Respiratory and Pulmonary departments. Patients may have additional charges depending on the services performed. Aerosol Bronchodilator Initial $ Aerosol Bronchodilator Subsequent $

5 CARDIOLOGY CHARGES The following charges reflect Hospital s most commonly offered Cardiology services. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required. They also do not include fees for physicians who will bill separately for their services. EKG 12-Lead Tracing $ Echocardiogram Color Flow Doppler $ Echocardiogram 2-Dimensional $ Echocardiogram Doppler $ Stress Test Exercise/Tracing $