Hospital Pricing Transparency
For price estimation please email or call our billing department at 518-828-8051
Standard Charges/Display of Shoppable Services
In compliance with new federal requirements*, Columbia Memorial Health (CMH) is making available a list of our standard charges for items and services that we provide as well as a price list of “shoppable services,” which are services that patients can schedule in advance.
The gross charge displayed is the dollar amount billed to insurance companies for services; however, it is typically not what CMH is paid for a service or what a patient will be responsible for. Payments for services are typically based on rates negotiated with insurance companies and government established fee schedules.
A patient’s potential financial liability is dependent on various factors that can include:
- actual charges for services provided
- insurer negotiated payment rates
- government established payment rates
- patient co-insurance and deductible responsibilities
- secondary insurance benefits, qualifying financial aid and prompt pay discounts
The standard charges and display of shoppable services do not include physician or other separately billable provider charges.
Columbia Memorial Health Standard Charges
Standard charges include the following:
Gross charge: The charge for an individual item or service that is reflected on a hospital’s chargemaster that is billed to all insurance companies, before any discounts are applied. (A hospital chargemaster is a comprehensive list of a hospital’s products, procedures, and services.)
Discounted cash price: The expected payment that applies to non-insured individuals who pay cash (or cash equivalent) for a hospital item or service.
Payer-specific negotiated charge: The PAYMENT that Columbia Memorial Health has negotiated with a third-party payer for an item or service.
De-identified minimum negotiated charges: The lowest PAYMENT that Columbia Memorial Health has negotiated with all third-party payers for an item or service.
De-identified maximum negotiated charges: The highest PAYMENT that Columbia Memorial Health has negotiated with all third-party payers for an item or service.
THE STANDARD CHARGE AMOUNT IS TYPICALLY NOT WHAT A PATIENT WILL BE RESPONSIBLE FOR PAYING.
If you have questions or need an estimate for services, please call Patient Financial Services at 518-828-8051.
We recommend that you also contact your insurance company for information about the plan’s payment amount and your patient liability amount or your plans benefit restrictions or coverage limitations.
This pricing information is intended to be informational only and is not necessarily reflective of a patient’s financial responsibility or the amount that will be paid by an insurance plan. A patient’s financial responsibility depends on actual services and procedures performed as determined by the patient’s doctor. Final determination of eligibility and benefits are determined at the time the claim is processed by the insurance plan.
Columbia Memorial Health Shoppable Services
This list represents 300 “shoppable services” that a health care consumer can schedule in advance. Examples of common shoppable services include imaging and laboratory services, medical and surgical procedures. This information is intended to make it easier for consumers to estimate the cost of care before going to the hospital.
If you have any questions, please contact Columbia Memorial Health at 518-828-8051.
This pricing information is intended to be informational only and is not necessarily reflective of a patient’s final financial responsibility or the amount that will be paid by an insurance plan. A patient’s financial responsibility depends on actual services and procedures performed as determined by the patient’s doctor. Final determination of eligibility and benefits are determined at the time the claim is processed by the insurance plan.
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*Section 2718(e) of the Public Health Service Act requires that each hospital operating within the United States, for each year, establish (and update) and make public a list of the hospital’s standard charges for items and services provided by the Hospital. Effective January 1, 2021, hospitals are required to make available a comprehensive machine-readable file with all items and services offered by the Hospital and a display of shoppable services in a consumer-friendly format.