Intermountain Health has published updated price transparency data for St. George Regional Hospital and Garfield Memorial Hospital, providing the standard charge lists required by the federal Hospital Price Transparency Rule. The disclosures include information on shoppable services and medical items, though the hospital system cautioned that these figures do not represent a guaranteed final cost for patients.
Understanding standard charge discrepancies
The pricing information released by both St. George Regional Hospital and Garfield Memorial Hospital represents the standard charges for medical items and services as mandated by federal regulations. However, Intermountain Health noted that these listings reflect prices paid by insurers and may not accurately represent an individual's actual financial responsibility.
Several factors can cause a discrepancy between the posted transparent pricing and the final bill. The hospital stated that the listed prices are based on what insurers pay for services, which might differ from a patient's specific share under their unique health plan. Additionally, the availability of certain insurer prices depends on whether the provider is covered under the terms of the patient's specific health plan.
Variables affecting final medical costs
The hospital system identified multiple variables that can alter anticipated costs during a hospital visit. Actual medical items and services furnished to a patient, including specific medications, may vary from what was originally expected. Furthermore, patients may receive supplies or services from physicians, practitioners, or contractors who are not directly employed by the hospital; the prices for those external services are not included in the published transparency lists.
Insurance contract limitations and risks
Intermountain Health also cautioned that an insurer may not have a contract with the hospital for all specific services provided. In such cases, the posted transparent prices would not apply to any services for which the insurer has not established a contract.
Contacting cost estimation specialists
For patients seeking more precise information regarding potential financial liability, Intermountain Health encourages contacting a Hospital Cost Estimation Specialist at (855) 442-8601 or via email. For Garfield Memorial Hospital, the specific contact email is INTCostEstimate@R1RCM.com, while St. George Regional Hospital patients can use the same phone resource.
Preparing for accurate cost estimates
To prepare for a cost estimate, the hospital recommends that patients have their medical procedure name or CPT (Current Procedural Terminology) code and their insurance information ready. For those paying directly without insurance, the system allows for searches without providing coverage details.
Using MyChart digital estimation tools
Intermountain Health provides digital tools for patients to estimate costs through MyChart. For users with a My\u0020Chart account, estimates can be generated by logging in, navigating to the 'Billing' section under the main menu, and selecting 'Estimates.' Users must then choose 'Create a New Estimate,' accept a disclaimer, and enter their procedure details and insurance or self-pay status.
Patients without a MyChart account can utilize a guest Price Estimator via a provided link. This process requires users to select an Intermountain Health location, accept the necessary disclaimer, and input their procedure name or CPT code along with their payment method to receive a printable estimate.
While the Centers for Medicare and Medicaid Services (CMS) requires hospitals to publish a Hospital Standard Charge list, Intermountain Health recommends using their specific estimation tools as they are considered more helpful and accurate for understanding estimated costs. The hospital warned that the Standard Charges list is not a price list and should not be used as a definitive estimate of patient payment.
According to the hospital, the charge amounts in the Standard Charges list rarely reflect the actual amount patients are asked to pay on a final bill. These figures can fluctuate throughout the year due to changes in medical and pharmaceutical items, and the hospital cannot guarantee the permanent accuracy of the posted pricing information.
Garfield Memorial Hospital specifically noted that no individual will be denied access to services due to an inability to pay and highlighted the availability of a discounted or sliding fee schedule based on family size and income.
For both locations, Intermountain Health encourages patients with insurance to contact their providers directly to understand copayments, deductibles, and out-of-pocket requirements. For uninsured or underinsured patients, the hospital directs individuals to its financial assistance website for information regarding discounts and other payment options.
