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Patient Price
Information List |
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| In compliance with state law, MedCentral Health System is
providing this price list containing our charges for room and board,
emergency department, operating room, delivery, physical therapy and other
procedures. The health system's charges are the same for all patients, but a
patient's responsibility may vary, depending on payment plans negotiated with
individual health insurers. Uninsured or underinsured patients should consult
with our admitting and billing staff to determine whether they qualify for
discounts. These prices are correct as of February 15, 2007. |
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| Room and Board -- Per Day Charges |
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Charges |
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| Coronary
care |
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CVICU |
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1,835.00 |
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Stepdown |
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780.00 |
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| Intensive
care |
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ICU |
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1,370.00 |
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Stepdown |
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780.00 |
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| Nursery |
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390.00 |
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| Oncology |
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490.00 |
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| Psychiatric
care |
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785.00 |
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| Routine
care |
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490.00 |
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| Labor and Delivery Charges |
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| The
following list does not include charges for anesthesia, drugs, or supplies
required for a particular delivery room procedure. Fees for physician
services or anesthesia administration are also not reflected, and will be
billed separately by your physician. |
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Charges |
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| Normal
Delivery |
Mom |
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4,524.00 |
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| Normal
Newborn |
Baby |
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1,489.00 |
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| Cesarean
Section Delivery |
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6,819.00 |
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| Fetal
Monitor- Flat Rate |
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110.00 |
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| Labor Room
per hour |
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66.00 |
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| Amniocentesis
* |
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93.00 |
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*(Other Tests may be done as well) |
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| Emergency Department Charges |
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| Emergency
Department charges are based on the level of emergency care provided to our
patients. The levels, with level 1 representing basic emergency care, reflect
the type of accommodations needed, the personnel resources, the intensity of
care and the amount of time needed to provide treatment. The following
charges do not include fees for drugs, supplies or additional ancillary
procedures that may be required for a particular emergency treatment. They
also do not include fees for Emergency Department physicians, who will bill
separately for their services. |
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Charges |
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| Level 1 |
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86.00 |
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| Level 2 |
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144.00 |
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| Level 3 |
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250.00 |
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| Level 4 |
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410.00 |
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| Level 5 |
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580.00 |
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| Critical
care |
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860.00 |
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| Level 2
Trauma Center - Activation |
3,400.00 |
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| Operating Room Charges |
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| Operating Room charges are based on the complexity level, with
level 1 being the most basic, for a particular operation There is an initial,
set-up charge as well as an additional charge for each 15 minutes while the
operation is being performed. |
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Set-Up Charge |
Additional 15-Minute
Charge |
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| Minor |
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200 |
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38.00 |
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| Standard |
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385 |
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502.50 |
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| Cardiac |
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570 |
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615.00 |
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| Physical Therapy Charges |
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| The following charges reflect the most common services offered
by our Physical Therapy department. Patients may have additional charges,
depending on the services performed. Most Charge Units are based upon 15
minutes. |
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| ANKLE/FOOT
STRAPPING |
21.00 |
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| ELECTRICAL
STIMULATION-ATTENDED |
42.00 |
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| ELECTRICAL
STIMULATION-UNATTENDED |
35.00 |
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| FUNCTIONAL
ACTIVITY/UNIT |
65.00 |
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| GAIT TRAINING/UNIT |
55.00 |
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| GROUP THERAPY/UNIT |
45.00 |
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| INITIAL EVALUATION
ACUTE (NON-PEDIATRIC) |
160.00 |
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| IONTOPHORESIS/UNIT |
58.00 |
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| MANUAL THERAPY/UNIT |
65.00 |
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| MECHANICAL
TRACTION/UNIT |
35.00 |
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| NEUROMUSCULAR
RE-ED/UNIT |
62.00 |
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| ORTHOTIC FITTING
TRAINING/UNIT |
53.00 |
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| PHYSICAL
PERFORMANCE TEST/UNIT |
49.00 |
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| PROSTHETIC
TRAINING/UNIT |
60.00 |
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| RE-EVALUATION-PT |
81.00 |
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| SELF CARE
MANAGEMENT TRAINING/UNIT |
62.00 |
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| SHOULDER STRAPPING |
21.00 |
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| THERAPEUTIC
EXERCISE/UNIT |
65.00 |
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| WHEELCHAIR MGT/UNIT |
65.00 |
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| WHIRLPOOL/UNIT |
45.00 |
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| WOUND CARE SMALL |
76.00 |
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| Occupational Therapy Charges |
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| The
following charges reflect the most common services offered by our
Occupational Therapy department. Patients may have additional charges,
depending on the services performed. |
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| ACTIVITY EVALUATION |
0.00 |
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| CLINICAL DRIVING
EVALUATION |
580.00 |
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| COGNITIVE
INTEGRATION |
65.00 |
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| COMMUNITY/WORKRE-INTEGRATION |
57.00 |
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| CONFERENCE |
45.00 |
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| CONTRAST BATHS |
42.00 |
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| DYNAMIC
SPLINT-APPLICATIONFINGER |
85.00 |
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| GROUP THERAPEUTIC
ACTIVITIES |
80.00 |
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| LEISURE
ASSESSMENT-(PER UNIT) |
78.00 |
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| MANUAL THERAPY
TECHNIQUES |
65.00 |
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| NEUROMUSCULAR RE-ED |
62.00 |
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| ON THE ROAD
TRAINING-PER 15MINUTES |
30.00 |
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| ORTHOTIC
FITTING/TRAIN |
53.00 |
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| OT EVALUATION |
160.00 |
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| OT RE-EVALUATION |
81.00 |
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| PARAFFIN BATH |
32.00 |
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| RECREATION
CONFERENCE |
42.00 |
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| RECREATION THERAPY
GROUP |
65.00 |
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| RECREATION THERAPY
INDIVIDUAL/UNIT |
49.00 |
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| SELF-CARING
MANAGEMENT TRAINING-UNIT |
62.00 |
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| SENSORY
INTEGRATION |
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65.00 |
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| STATIC SPLINT
APPLICATION - FINGER |
79.00 |
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| STATIC
SPLINT APPLICATION - LONG ARM |
170.00 |
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| STATIC SPLINT
APPLICATION - SHORT ARM |
102.00 |
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| THERAPEUTIC ACTIVITIES |
65.00 |
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| THERAPEUTIC EXERCISES |
65.00 |
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| THERAPEUTIC
MASSAGE-EA 15 MIN |
50.00 |
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| THERMAL-CRYO MODALITY |
25.00 |
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| ULTRASOUND-EA 15 MIN |
45.00 |
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| WHIRLPOOL |
45.00 |
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| Pulmonary Therapy Charges |
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| The
following charges reflect the most common services offered by our Pulmonary
Therapy department. Patients may have additional charges, depending on the
services performed. |
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| ARTERIAL PUNCTURE |
30.25 |
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| BLOOD GAS W/COOX |
119.00 |
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| CARDIAC REHAB VISIT |
106.00 |
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| CARDIAC REHAB PHASE
III |
73.00 |
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| CPAP (DAILY) |
165.00 |
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| INCENTIVE
SPIROMETER |
52.00 |
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| MDI-INITIAL I |
52.00 |
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| MDI-SUBSEQ I |
52.00 |
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| MDI-SUBSEQ II |
52.00 |
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| SPONT.
AEROSOLTX-INITIAL |
52.00 |
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| SPONT.
AEROSOLTX-SUBSEQ. |
52.00 |
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| VENTILATOR-DAILY |
605.00 |
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| VENTILATOR-INITIAL
DAY |
605.00 |
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| X-Ray and Radiological Charges |
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| The following charges reflect the hospital's 30 most common
x-ray and radiological procedures. |
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| ANKLE |
164.00 |
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| BARIUM SWALLOW
(ESOPHAGUS) UPPER GI |
313.00 |
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| CHEST PA AND
LATERAL |
168.00 |
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| CAROTID 75671 BILAT
CEREBRAL |
1,420.00 |
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| CHEST(ONE VIEW
ONLY) |
121.00 |
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| ELBOW, 3 VIEWS |
173.00 |
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| FOOT, 3 VIEWS |
170.00 |
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| FOREARM |
151.00 |
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| GI, SMALL BOWEL |
486.00 |
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| HAND |
135.00 |
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| HIP, 2 VIEWS |
170.00 |
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| IVP (ADULT) |
396.00 |
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| KNEE |
153.00 |
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| KUB |
142.00 |
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| KUB AND UPRIGHT KUB |
176.00 |
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| KUB UPRRIGHT - KUB
PA CHEST |
266.00 |
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| LEG (TIBIA/FIBULA) |
151.00 |
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| MODIFIED
BARIUM/COOKIE SWALLOW |
283.00 |
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| PELVIS |
132.00 |
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| PTA-VENOUS |
2,630.00 |
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| RIBS,UNILATERAL |
200.00 |
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| SHOULDER 2-VIEWS |
169.00 |
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| SHOULDER, 1 VIEW |
138.00 |
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| SPINE,
CERVICAL,MULTIPLE VIEWS (AP,LATERAL,FLEX,EXT) |
257.00 |
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| SPINE,
CERVICAL-ROUTINE VIEWS |
244.00 |
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| SPINE, LUMBOSACRAL |
202.00 |
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| SPINE, THORACIC |
196.00 |
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| WRIST |
165.00 |
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| MRI UPPER EXTREMITY
W&WO CONTRAST |
1,710.00 |
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| MRI THORACIC SPINE
W/O CONTRAST |
1,770.00 |
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| MRI THORACIC SPINE
W&W/O CONTRAST |
2,300.00 |
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| MRI PELVIS W/O
CONTRAST |
1,770.00 |
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| MRI PELVIS
W&W/O CONTRAST |
1,990.00 |
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| MRI ORBITS FACE
& NECK W/O CONTRAST |
1,600.00 |
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| MRI ORBITS FACE
& NECK W&W/O CONTRAST |
1,800.00 |
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| MRI LUMBAR SPINE
W/O CONTRAST |
1,700.00 |
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| MRI LUMBAR SPINE
W&W/O CONTRAST |
2,120.00 |
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| MRI LOWER EXTREMITY
W/O CONTRAST |
1,840.00 |
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| MRI LOWER EXTREMITY
W&W/O CONTRAST |
1,890.00 |
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| MRI SPINE
CANAL-CERVICAL W/O CONTRAST |
1,600.00 |
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| MRI CERVICAL SPINE
W&/WO CONTRAST |
2,230.00 |
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| MRI BRAIN W/O
CONTRAST |
1,670.00 |
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| MRI BRAIN W&W/O
CONTRAST |
1,770.00 |
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| MRI ABDOMEN W/O
& WCONTRAST |
1,980.00 |
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| MRA NECK W&W/O
CONTRAST |
1,240.00 |
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| MRA HEAD |
955.00 |
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| MRA ABDOMEN
W&W/O CONTRAST |
1,800.00 |
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| CT BRAIN W/O
CONTRAST |
820.00 |
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| CT BRAIN W/CONTRAST |
1,050.00 |
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| CT BRAIN W&W/O
CONTRAST |
1,170.00 |
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| CT PELVIS WITH ORAL
CONTRAST |
845.00 |
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| CT PELVIC WITH IV
& ORAL CONTRAST |
1,060.00 |
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| CT ABDOMINAL W/O
CONTRAST |
915.00 |
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| CT ABDOMEN
W/CONTRAST |
1,080.00 |
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| CT ABDOMEN W&WO
CONTRAST |
1,350.00 |
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| CT CHEST W/O
CONTRAST |
940.00 |
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| CT CHEST W/CONTRAST |
1,120.00 |
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| CT CHEST W&W/O
CONTRAST |
1,300.00 |
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| CT CERVICAL SPINE
MULTIPLE W/O CONTRAST |
1,040.00 |
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| CT LUMBAR SPINE
MULTI-LEVEL |
1,090.00 |
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| CT NECK W/CONTRAST |
1,010.00 |
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| CT ORBIT SEL PFOS
OUT/MID/INEAR |
835.00 |
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| CT FACIAL BONES |
740.00 |
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| CT 3-D
RECONSTRUCTION |
575.00 |
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| CT GUIDANCE
PLACEMENT RADIAT.FIELDS |
530.00 |
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| CT GUIDANCE FOR
NEEDLE BIOPSY |
820.00 |
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| CTA, CHEST
W&W/O CONTRAST |
1,190.00 |
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| CTA ABDOMEN
W&W/O IV CONTRAST |
1,300.00 |
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| CTA PELVIS
W&W/O IV CONTRAST |
1,310.00 |
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| Laboratory Charges |
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| The following charges reflect the hospital's 30 most common
laboratory procedures. |
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| AMYLASE
SERUM |
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51.00 |
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| CALCIUM
IONIZED |
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63.00 |
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| CBC |
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60.00 |
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| CBCW/MACHINE
DIFF.-SH |
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60.00 |
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| CHEM8 (BASIC METABOLIC) |
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86.00 |
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| COMPREHENSIVE
METABOLIC PANEL |
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119.00 |
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| CREATININE,SERUM |
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26.00 |
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| CULTURE,
BLOOD |
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95.00 |
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| CULTURE,
URINE |
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48.50 |
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| GLUCOSE |
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23.75 |
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| HEMATOCRIT |
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20.00 |
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| HEMOGLOBIN |
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19.00 |
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| HEMOGLOBIN
A1C |
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63.00 |
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| HEMOGRAM |
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42.00 |
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| HEPATIC
FUNCTION-PANEL |
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82.00 |
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| LIPIDPROFILE |
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99.00 |
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| MAGNESIUM
SERUM |
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38.75 |
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| MYOGLOBIN
(AMI PROFILE) |
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89.00 |
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| PARTIAL
THROMBOPLASTIN TIME |
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19.50 |
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| PHOSPHORUS
SERUM |
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26.00 |
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| POTASSIUM,SERUM |
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21.50 |
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| PROTHROMBIN
TIME |
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28.00 |
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| RENAL
FUNCTION PANEL |
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66.00 |
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| SENSITIVITY |
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52.00 |
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| THYROID
STIMULATING HORMONE |
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92.00 |
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| THYROXINE
T4 FREE |
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70.00 |
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| TROPONIN-I |
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80.00 |
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| URINALYSIS
W/OMICROSCOPIC |
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21.50 |
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| VENIPUNCTURE |
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14.00 |
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| MedCentral Collection and Billing
Policies |
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PHILOSOPHY:
MedCentral Health System has established a mission to meet the medical
needs of the communities it serves. This mission requires MedCentral to
maintain a strong financial position. To this end, we have established a
policy of communicating the financial expectations to the patient. We will
also provide the patient with information on payment and charity care
options.
The employees of MedCentral Health System will always keep in mind the
patient’s financial situation and preserve the dignity of those involved.
With the exception of “Life Style” procedures, no clinical services will be
denied for an inability or unwillingness to pay.
POLICY:
MedCentral Health System’s billing and credit policies are summarized
below.
Third Party Insurance
• MedCentral will bill Medicare and Medicaid.
• MedCentral will bill third party commercial payers on behalf of the
patient. We offer 45 days to the insurance company before you will be
contacted to assist with the resolution of any unpaid insurance balance. If
there is no resolution the account will become patient liability and the
patient will be billed.
• MedCentral will not bill third party auto insurance if there is medical
coverage available.
• MedCentral will not wait for a third party liability carrier or sued
individual to pay a claim before enforcing our right to payment. MedCentral
will not accept a letter of protection from an attorney involved in a law
suit to recover third-party damages.
• MedCentral will honor discounts only with contracted insurance
carriers.
Uninsured, Unresolved and Self-Pay Balances
• Emergent, Urgent and Labor and Delivery services covered under EMTALA
(Emergency Medical Treatment and Active Labor Act) are not subject to prior
payment.
• Known Deductibles, Copay and Coinsurance amounts are due at the time of
service.
• Non-covered, self-insured, uninsured and “life style” services are
payable at the time of service. (Life style procedures are defined as not
medically necessary procedures such as non-restorative cosmetic
surgery.)
• Patient balances that cannot be paid prior to service and balances after
insurance payment or denial must be resolved in one of the following
methods:
- Payment in full from personal funds
- Bank Loan Program underwritten by MedCentral
- Limited term time payments (Limited to 6 months)
- Uncompensated or Charity Care approvals
• Patient balances not resolved in one of the methods above will be billed
on a prescribed time table over a 120 day period. During each of those
billing encounters, and calls from a financial counselor will include
information about the above payment options as well as our uncompensated care
program.
• If the account has not had a satisfactory resolution within 120 days the
claim may be submitted to an outside agency for professional collection
assistance. |
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| Consumers can
access a number of government and private Websites, which provide additional
information on hospitals' charges and quality. For a complete listing of
available online resources, please visit the Consumer's
Guide to Quality Health Care in Ohio at
www.ohanet.org/portal. |
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