The attached machine-readable file contains certain charge and rate information for items and services that may be offered by CarePartners Orthotics & Prosthetics. This information is subject to the following:
- The file does not contain information concerning patient's expected copayments, deductible amounts, or coinsurance obligations. For payment estimates specific to the amount you may owe for items and services you may receive at this hospital, please call 800-370-1983.
- The file will be fully updated on an annual basis. The "Last Full Update" date contained in the file reflects the date the file was last fully updated. The file may also contain technical revisions, corrections or additions after the Last Full Update, which are noted using a "Last Revision" date. Changes in charges, rates, network participation or other data elements that become effective following the date of the Last Full Update may not be shown, regardless of the Last Revision date.
- Rates are based upon the specific facts and circumstances of the care provided to an individual patient. These may include, among other things, (1) the patient's length of stay, (2) the severity of illness, (3) other items and services furnished to the patient (i.e., drugs and implants that vary by the product used), and (4) the overall cost of a stay.
- Comparisons of rates within the file between payers or comparison of files between hospitals will not reflect distinctions in prices due to variations in pricing methodology. For example, if an item or service is priced as a case rate (a set rate for an episode of care) with a particular payer or for a particular hospital, but as a per day rate with a different payer or hospital, then these rates cannot be compared without first determining the patient's length of stay and then applying the applicable contractual enhancements (e.g., stoploss or trauma activation).
- The values in this file reflect a single unit of pricing (e.g., case rates, percent of charges [fee schedule or Medicare], DRG Base Rates, Daily Rates, etc.) and do not reflect variations that may occur based upon pricing structures that, among other things, (1) price day 1 differently from day 4, (2) apply weights to the negotiated rate, or (3) are subject to add-ons based upon individual patient circumstances.
- For ER Levels 1 through 5, the file reflects an average rate of the combined levels that are priced using the same methodology. For example, if levels 1 - 4 are case rate and level five is a percent of charge, levels 1 - 4 will be reflected as an average, combined rate and level 5 will be separately listed as a percent of charge.
- For commercial products that are included on the same agreement and with the same payment methodology, the file will reflect an average rate for the agreement.
- The file does not include information for non-hospital items and services, including the rates for care provided by physicians and other professionals that are not Mission Health employees.
- The minimum and maximum results in the file represent the high and low payer-specific negotiated charge by service description and reimbursement type (i.e., percent of charge/Medicare/fee schedule or dollar amount) and may or may not include identical coding for the service description. Because items and services are priced differently by payers (i.e., case rate, daily rate, base rate), the minimum and maximum rates may not reflect the highest or lowest dollar value for a given service across all payers. For example, the maximum rate for an item may show Payer A's rate (the highest rate shown), but when the payers' rates are applied to an actual patient stay, Payer B's rate may in fact be the maximum rate for that particular stay.
- CarePartners Orthotics & Prosthetics