Date: 2025-05-01 Page is: DBtxt003.php txt00028174
HEALTH
UNDERSTANDING THE SYSTEM
Standard Charges for Services Provided
UNDERSTANDING THE SYSTEM
Standard Charges for Services Provided
Original article:
Peter Burgess COMMENTARY
Peter Burgess
You may have heard that as of January 1, 2019, hospitals have price information online. Here is important information to help you understand what you are looking at.
About the “Chargemaster”
- A chargemaster is a list of medical codes and prices for everything a hospital provides to patients.
- Each hospital has its own chargemaster list that is used for billing purposes.
- The chargemaster list is not the negotiated price between hospitals and insurers, and it is not the price that most patients would pay for care.
- The chargemaster list is not the best tool for patients to figure out the cost of their health care services.
- Most people would not know all the medical codes that would be used for their care before they receive treatment.
- The prices on the chargemaster list are not the actual payment rates that hospitals receive. And chargemaster prices are almost never the actual amount a patient is responsible for.
Please watch this important video, Understanding Your Charge Master, about hospital pricing information.
Understanding Your Chargemaster
How Much Will I Pay?
The best way to understand what you will pay out-of-pocket is to work with your hospital and your insurer. In general:
- Individuals with insurance will pay any copayments, coinsurance, or deductible due.
- Individuals without insurance might be eligible for financial assistance or charity care, or may be able to receive a reduced price from the hospital.
Understanding Your Chargemaster
The Hospital and Healthsystem Association of PA
63 subscribers
2,328 views
Jan 2, 2019
“What a Chargemaster is (and is not)”]
Transcript 0:00
- [Music]
- a charge master is a list of prices for
- every procedure service or good provided
- by a hospital by law hospitals must post
- this information it is important to
- understand what a charge master is and
- what it is not charges are not what most
- people pay for care in most cases the
- amount actually paid is much lower a
- charge is the maximum total amount a
- hospital can bill a patient's insurer
- insurers negotiate much lower payment
- rates with hospitals the charge master
- does not show these lower negotiated
- rates or any discounts provided to
- patients based on financial need a
- charge master is not user friendly most
- people will be unsure of the medical
- codes that would be included to figure
- out the charges for a procedure or
- treatment the best way to understand
- what you
- pay out of pocket is to work with your
- hospital and your insurer hospitals
- offer financial counseling and help for
- people who have insurance as well as
- those who do not contact your hospitals
- financial office or patient advocate or health