Frequently Asked Questions

At Southwest General, we want you to know that we are here for you. Please contact our Financial Clearance department at (440) 816-4701 for a customized estimate of your out-of-pocket costs (deductible, co-insurance and co-pay) based specific to your health insurance plan for the services you need. You can also access our easy-to-use Patient Bill Estimator tool to get a customized estimate after filling out the required fields.

What is a Chargemaster?

A chargemaster is a comprehensive list of charges for each inpatient and outpatient service provided by a hospital – each test, exam, surgery or other procedures, room charges, etc.

• Given the broad scope of services provided by hospitals 24 hours a day / 7 days a week, a chargemaster contains thousands of services and charges.
• Health insurance companies contract with hospitals to care for their customers. Hospitals are paid the insurance company’s contract rate, which generally is significantly less than the amount listed on the chargemaster.
  • The insurance company’s contract rate, not the chargemaster, is the basis for determining the patient’s actual out of pocket expenses.
• An individual hospital’s charges vary based on its unique range of services, adoption of new medical technologies, government underfunding, patient demographics and other local and regional factors.
• Use our Patient Bill Estimator tool for understanding your cost for the services provided.

How is information shared with patients and families?

The chargemaster is not a useful tool for consumers who are comparison shopping between hospitals.

• Our hospital employs financial counselors and other resources to help our patients understand their financial obligations.
  • Our Financial Clearance Department can be reached at (440) 816-4701 between the hours of 8:00am – 4:30pm, Monday through Friday.
  • You can also utilize our Patient Bill Estimator tool for a customized quote of your estimated out-of-pocket costs.
• We encourage patients to reach out and ask detailed financial questions – especially before scheduled services.
• Our hospital is ready to help patients and their families understand their financial obligations at any time during the treatment process.

Are charges different from payments?

Yes, charges are different from payments. Chargemaster information is not particularly helpful for patients to estimate what health care services are going to cost them out of their own pocket.

• Chargemaster amounts are almost never billed to a patient or received as payment by a hospital.
• The chargemaster amounts are billed to an insurance company, Medicare, or Medicaid, and those insurers then apply their contracted rates to the services that are billed. In situations where a patient does not have insurance, our hospital has financial assistance policies that apply discounts to the amounts charged. More information on our financial assistance policies can be found here.
• Each hospital has different proportions of Medicare, Medicaid, commercial insurance or uninsured patients, which adds to the complicated nature of hospital billing.
• Every insurer pays the hospital differently. Medicare and Medicaid generally pay less than the actual cost of caring for patients.
• There are also patients who, unfortunately, can’t pay their hospital bills. As Ohio’s health care safety net, hospitals treat uninsured and underinsured patients every day.

Why do hospital costs of caring for patients vary?

Every patient’s case is special and requires different levels of care. Hospitals are prepared with doctors, nurses and high-tech equipment around the clock for illness or injury – from a twisted ankle to a major accident to a natural disaster.

• The price a patient sees on the hospital bill reflects all the people who care for them and keep the hospital operating, not just the services provided, such as:
  • Nurses and caregivers at the bedside
  • Pharmacists, lab technicians, food service staff, environmental service professionals and security personnel who, among many others, keep the hospital running 24 hours a day / 7 days a week / 365 days a year
  • Specialty care providers
• Hospital costs have many factors, such as staffing, equipment, maintenance costs and the differences in care needed by each patient. Key components of hospital costs that vary by region, community and individual hospital include:
  • Services provided for the patient’s unique care needs
  • 24 hours a day / 7 days a week / 365 days a year readiness to meet the community’s health care needs
  • Charity care for people unable to pay
  • Medicare and Medicaid underpayments – programs that pay the hospital less than the cost of caring for patients with health coverage through the programs

Are Charges the Same for Every Patient?

The list of charges is the same for all patients. However, the total charges for an individual patient often vary from one patient to another for a number of reasons, including:

• How long it takes to perform the service or how long it takes you to recover in the hospital
• Whether the service or procedure you receive is more or less difficult than expected
• What kinds of medication you require
• Whether you experience complications and need additional treatment
• Other health conditions you may have that may affect your care

What is Not Included in the Chargemaster list?

The hospital’s chargemaster does not include charges for services provided by the doctor (or doctors) who treat you while you are at the hospital. You may receive separate bills from the hospital and the doctors involved in your care.

Here is a partial list of health care providers who may bill you separately:

• Your personal doctor, if he/she sees you in the hospital
• The surgeon who performs your procedure
• The anesthesiologist who works with the surgeon
• The radiologist who reads your x-rays or other imaging
• Other doctors who may be consulted by your doctor during your time in the hospital
• Laboratory testing

If the chargemaster is not valuable or helpful why show it?

Southwest General Health Center and all hospitals across the nation are required to share this information effective January 1, 2019 as part of the Medicare Inpatient Prospective Payment Final Rule. As explained above, the list price of the items on our standard charge list is not an accurate way to estimate the out of pocket expense for a given service or procedure. For a better estimate of the cost of your care, please use our online Patient Bill Estimator tool, which is available to you 24 hours per day, 7 days a week, 365 days a year. You can also contact our Financial Clearance Department (440) 816-4701 for a detailed quote.

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