Cost Estimation Tool
The purpose of the cost estimation tool is to enable you to self-generate out-of-pocket expense estimates. The platform validates insurance coverage, then delivers out-of-pocket estimates specific to your current health benefit. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. The estimates are based on the selected provider’s contract rates/fee schedule with your insurance carrier. Your actual cost may be higher or lower than the estimate you generate for multiple reasons including:
- if the decisions made by you or your health care provider as to what services you will receive is different from the services selected during the estimation process.
- if the location of where your services are received changes after the estimation process.
- if your year-to-date benefit information changes from the time at which you receive this estimate and the time at which you receive care.
- if your healthcare provider’s contract with your insurance carrier changes.
- if you have a unique plan design that is not currently supported by the tool
- if a care path includes anesthesia services, your cost estimate reflects costs based on the use of a network anesthesia provider. Your actual costs may be different if you receive anesthesia services from an out-of-network provider.
Charge Description Master & DRG Information
This hospital determines its standard charges for patient services with the use of a chargemaster or similar system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for services provided at this hospital.
The chargemaster is similar in concept to the manufacturer’s suggested retail price (MSRP) on a vehicle. It is the starting price of each service performed and goods consumed associated with the individual patient’s treatment. The chargemaster rates are updated from time to time to accurately reflect the hospital’s expenses to operate.
Standard charges shown in the attached file do not necessarily reflect what a patient may pay. Government insurance plans such as Medicare and Medicaid do not pay the chargemaster rates, but rather have their own set rates which hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with managed care payors and may or may not reflect the standard charges. Patients without commercial insurance or not covered by a government health care plan should contact the hospital prior to a procedure to discuss charges, alternative pricing, and payment terms.
Questions and comments should be directed to the MRMC business office at (979) 241-5503.