Q: I cannot find Carle's prices on their website. As of Jan. 1, all hospitals are required to post their chargemasters on their websites. I want to see their prices and compare them to OSF, and also just know what to expect when I have specific procedures. Where are they?
A: It actually has been posted by both Carle and OSF HealthCare since Jan. 1, as required by the Centers for Medicare and Medicaid Services. But it takes a few clicks to get there. For Carle, it's under "transparent pricing," and for OSF, it's under "standard charges."
Here are shortened direct links.
For Carle: bit.ly/2E9s9i4.
For OSF HealthCare hospitals: bit.ly/2GJUtM1.
Hospitals are required to post both their standard charge lists — each of which includes thousands of items — and their average charges by diagnostic-related group (referred to as DRG) for inpatient stays.
Carle has posted two sets of lists for Carle Foundation Hospital and Carle Hoopeston Regional Health Center, with one set for basic charges and one for DRGs.
OSF said it has all the required information on the single lists posted for each hospital.
As patients have been discovering, these lists of billing codes and prices aren't much help in making comparisons, or even in determining what any one procedure or stay at a specific hospital will cost.
One reason is that each patient and hospital stay is unique, and the medications used and the supplies and services connected with any one procedure — say, a hip replacement — won't necessarily be the same for another patient undergoing the same procedure, said Carle Senior VP and Chief Revenue Cycle Officer DAWN WALDEN.
And even if there was consistent coding across facilities, chargemaster rates are just a starting point, Walden said.
Insurers negotiate rates for various health services on behalf of their members, and patients will face charges based on their own health plans' negotiated rates and what those plans require them to pick up in out-of-pocket costs.
"This is a place to start, but quite frankly, for people to get a handle on what they will pay out of pocket has nothing to do with the charges that are posted," Walden said.
Both Carle and OSF advise the best way to get a pre-estimate on the cost of a non-emergency hospital stay or procedure is to call your insurer and/or hospital in advance.
Health Alliance Medical Plans, for example, has a treatment cost calculator tool available at its YourHealthAlliance.org member site.
OSF HealthCare recently expanded its own price request tool on its website. This tool allows patients to call or fill out a form with some basic information and OSF will send them an estimate within one business day, spokeswoman KODI SMITH said.