What is the undiscounted price?
The undiscounted price is the amount billed for a service rendered without complications or exceptional circumstances; it does not include the negotiated discount for an in-network or out-of-network service or the cost paid by a third party.
What is a CPT code?
CPT stands for current procedural terminology. The code is a five digit number that corresponds to a procedure or service used for billing purposes (
What are facility fees?
A facility fee is a charge billed by a health care facility or provider that is in addition to fees billed for a health care provider's professional services. The facility fee is intended to cover building, electronic medical records systems, billing, and other administrative and operational expenses.
What are the 6 sections of Category I, CPT codes?
The 6 sections are surgery, anesthesiology, medicine, radiology, pathology and labs, and evaluation and management. The categories are determined by the American Medical Association.
How will this bill help me figure out the exact cost of what I will pay out-of-pocket? Providers, hospitals, and insurers are now required to provide you with a personalized good faith estimate (GFE). If you speak directly with your insurer for a GFE, they can tell you what your co-pay and deductible will be for a specific health care service or procedure.
What if I'm at a hospital that is in-network?
If you receive your health care services at your local, in-network clinic, you can still see what they charge for certain services or procedures. You can also ask for a GFE to estimate what your out-of-pocket or co-pay will be.
What if I don't have insurance?
If you don't have insurance, you can use the price list to shop around for your health care service. To get an accurate estimate of what you might pay for a procedure, providers and hospitals are now required to give you a personalized GFE if you ask for one.
When should I expect to see a price list at my local clinic?
The implementation process for disclosing health care costs will begin January 1, 2019. Health care providers and hospitals should have their price information posted in their reception area or website (if they have one) no later than March 31st.