Intermountain Health released updated price transparency information for Park City Hospital and St to St. George Regional Hospital on Friday, outlining the methods available for patients to estimate the costs of medical services and supplies. The hospital system emphasized that while standard charges are published in accordance with federal rules, these figures may not reflect a patient's actual financial responsibility.
Understanding federal pricing rules
The pricing information provided for both Park City Hospital and St. George Regional Hospital represents the costs required by the federal Hospital Price Transparency Rule. Intermountain Health noted that these listings reflect the prices paid by insurers for services, which may differ significantly from what a patient owes under their specific health plan.
Factors affecting final medical bills
Several factors can cause the final medical bill to vary from the initial estimates provided online. According to the hospital, actual medical items and medications furnished during a visit may differ from what was anticipated. Additionally, patients may receive services or supplies from physicians, practitioners, or contractors who are not employed by the hospital; such costs are not included in the published transparency listings.
Insurance coverage and price availability
Intermountain Health cautioned that the posted prices for insurers are only available if the patient's insurance provider covers those specific medical items or services under their plan terms. Furthermore, the hospital noted that its posted prices may not apply to services for which an insurer has not established a contract.
Determining ultimate patient financial liability
The hospital system clarified that these listings do not constitute a guarantee of pricing, coverage, benefits, or payments. A patient's ultimate financial liability is determined by the specific items and services billed by the hospital, the individual terms of their insurance policy, and their current benefit status, including deductibles, co-insurance, copayments, and out-of-pocket maximums at the time care is received.
Using tools for cost estimation
To assist patients in navigating these costs, Intermountain Health provides tools for both MyChart users and guests. Patients without a MyChart account can use a guest Price Estimator by visiting a specific link, accepting a disclaimer, and entering their medical procedure name or CPT code along with their insurance or self-pay information.
Step-by-step MyChart estimation process
For patients who utilize MyChart, the process involves logging into their account, navigating to the 'Billing' section of the main menu, and selecting 'Estimates.' From there, users can choose 'Create a New Estimate,' select the appropriate Intermountain Health location, accept the disclaimer, and enter their procedure or CPT code to receive a printable estimate.
Intermountain Health encourages patients to obtain hospital cost estimates before scheduling any non-urgent hospital services. To achieve the most accurate out-of-pocket estimates, the hospital recommends that patients with insurance contact their providers directly to understand current benefits and specific requirements like copayments or deductibles.
For those who are uninsured or underinsured, Intermountain Health noted that patients may qualify for discounts, financial assistance, or other payment options. The hospital directs these individuals to its dedicated financial assistance website for more detailed information.
While the Centers for Medicare and Medicaid Services (CMS) requires hospitals to publish a Hospital Standard Charge list, Intermountain Health stated that its other provided services are recommended as more helpful and accurate resources 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 for patient payments.
The hospital cautioned that charge amounts in the standard charges list rarely reflect what patients are actually asked to pay on a final bill, as pricing can fluctuate throughout the year for certain medical and pharmaceutical items. Because of these variables, the hospital stated it cannot guarantee the accuracy of the posted pricing information.
Patients seeking more precise information regarding potential financial liability can contact a Hospital Cost Estimation Specialist. Intermountain Health maintains a Cost Estimate Team available Monday through Friday, from 8 a.m. to 5 p.m., at (855) 442-8601 or via email at hospitalcostestimate@intermountainhealthcare.org.
For inquiries regarding existing or past medical bills, the hospital directs patients to contact its Billing Customer Service department.
