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.
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
- 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
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:
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.