Pricing FAQs
We are committed to providing meaningful pricing information to consumers so they can understand financial responsibilities to make informed healthcare decisions.
Obtaining pricing information
We know how important it is for patients to have healthcare pricing information. We are committed to making this information available so you can better anticipate and understand potential financial responsibilities to make informed healthcare decisions.
What is pricing transparency?
"Pricing transparency" is the term used to describe initiatives in the healthcare industry designed to provide meaningful pricing information to consumers. The healthcare industry is often complex and difficult for patients to navigate. We are committed to presenting pricing information for common services through this website in an accessible manner to promote better understanding while also providing helpful information about financial assistance available, definitions of key terminology and key financial policies.
How to obtain a patient payment estimate online
You can obtain a patient payment estimate online using our patient payment estimator online tool. This tool will ask you for a few pieces of important information regarding your health coverage plan (if applicable) and the services you are considering.
Uninsured and self-pay patients are also entitled to a separate Good Faith Estimate under federal law. If you are an uninsured patient who intends to schedule medical treatment and would like to request a Good Faith Estimate, please contact your provider.
How to obtain a patient payment estimate by phone
If you prefer to obtain an estimate by phone, we have a team you can contact toll-free for prospective service quotes by calling us at (833) 634-6306.
Frequently asked questions
The following are answers to some frequently asked questions regarding patient financial resources.
Are the Online Pricing Estimates described here the same as the Good Faith Estimate that is required to be provided to uninsured and self-pay patients?
No. This website provides online pricing estimates for all patients, but uninsured and self-pay patients are entitled to a more detailed cost estimate for scheduled services after January 1, 2022. Uninsured and self-pay patients considering the cost of service are encouraged to contact their provider directly to request a compliant Good-Faith Estimate.
What services are included in this online pricing estimate?
If you are viewing estimates provided on this website, the pricing includes:
- Any services handled by the staff of the hospital within the walls of the hospital
- Equipment use
- Estimated room and board (for inpatients)
- Medications administered during your service
- Nursing care
- Nutritional services
- Supplies
What services are excluded from this online pricing estimate?
You will be billed separately for services provided to you from your personal physician or other physicians related to your hospital stay. This can include fees related to specialists, anesthesiologists, pathologists and radiologists.
Independent laboratory and radiology services, such as electrocardiogram (ECG or EKG), X-ray and lab work analyses, will be billed separately.
Uninsured and self-pay patients are entitled to a more detailed cost estimate for scheduled services after January 1, 2022. Uninsured and self-pay patients considering the cost of service are encouraged to contact their provider directly to request a compliant Good-Faith Estimate.
What does "uninsured" mean?
A patient is considered "uninsured" if they do not have insurance coverage for hospital services from a third party such as Medicare, Medicaid, Workers' Compensation or another insurance company. Other common terms used when referring to uninsured patients are "self-pay "and "private pay."
What information do I need to obtain an estimate by phone?
It is a good idea to contact your physician's office to get the best description possible of the services that you need. Then, if you have insurance, contact your insurance company and make sure that the services required are "covered services" under your specific plan. If they are not "covered," you would be considered "uninsured" for these services.
Please try to have the following information on hand so that you can obtain the best estimate:
- Description of services needed — We will need to know as much information as possible about the specific services needed as described by your physician.
- Physician's or specialist's name — For example, if you are having surgery, we will want to know the surgeon's name.
- Types of services needed — We need to know if you will be admitted to the hospital as an inpatient overnight, or if you are expected to be treated on an outpatient basis.
If you have insurance, we will also need:
- Your insurance card — Please have your card available so that, if needed, you can provide the following information:
- Group name and number
- Name of phone number of insurance company
- Policy holder's name
- Policy number
- Type of policy (such as HMO, PPO, POS, Indemnity)
- Policy holder's personal information — It is possible that the insurance company will want us to verify the Social Security number and date of birth of the person named as the primary insurance policy holder.
Can I get an exact pricing quote on this online pricing estimator?
Uninsured and self-pay patients are entitled to a more detailed cost estimate for scheduled services after January 1, 2022. Uninsured and self-pay patients considering the cost of service are encouraged to contact their provider directly to request a compliant Good-Faith Estimate.
Unfortunately, we are unable to provide exact pricing quotes through this online payment estimator tool. We will do our best to provide you with a pricing range based on our hospital's historical pricing for comparable services.
Price quotes are not guaranteed because the services used to compute the quote can vary from the services that are ultimately provided. Other variables include:
- Additional tests or services ordered by your physician
- Changes in treatment plan
- Unforeseen complications
- Variations in the clinical needs of each patient
What is expected in terms of payment?
Similar to your visits to your physician's office, we request payment at the time of service. If you have insurance or other coverage, you will be asked to pay your copayment, coinsurance and/or deductible upon arrival at the hospital or in advance when you are pre-registered. After your insurance company processes your claim, we will send you information about any amount you may still owe.
If you are uninsured, we request payment at the time of service for the estimated price of your services. We can also work with you to arrange monthly payments. If, after your services are received, any additional payment is due, we will send you information about any amount you may still owe. If you receive emergency care and cannot pay for your services, with your cooperation, our financial counselors will evaluate whether you qualify for local and state programs, including county assistance and Medicaid, or our financial assistance programs.
Do you have a financial assistance policy or a charity policy?
Through our financial assistance and charity policies, we provide free hospital care for patients that have received non-elective care, who do not meet qualifications for Medicaid and whose income is less than 200 percent of the federal poverty level in most cases. To qualify for this free care, you must complete a financial assistance application and provide some documents to support your income. For patients with balances greater than $1,500 and whose documented income is between 201 and 400 percent of the federal poverty level, we have an expanded financial assistance policy that may reduce the amount you owe.
Our full Financial Assistance Policy is outlined here.
For patients who do not meet the charity criteria and will be expected to pay for services out of pocket, we offer a discount similar to managed care. All uninsured patients, excluding those receiving cosmetic procedures and certain "package" procedures, will be given an uninsured discount.
How does the insurance billing process work?
If you are insured, a claim will be sent to your insurance company. After they receive the claim, the insurance company may contact you for additional information. Please respond to your insurance company's questions as quickly as possible, so their payment is not delayed.
It usually takes 30 to 45 days for your insurance company to pay your claim. After they pay us, we will provide you with information about any amount you may owe that you did not already pay.
Please keep in mind that your policy is a binding agreement between you and your insurance company. If you did not follow your insurance plan's terms, they may not pay for all or part of your care.
What do I do if I need more information?
Because it is our goal to provide patients with useful information, we feel it is our responsibility to share more with you about some of the complications involved in determining patient financial responsibility.
Providing you with an estimate of your potential costs is an imperfect process and although we would like to guarantee our pricing estimates, it would be inappropriate to do so as there are many reasons the patient payment may be more or less than what we initially estimate.
All estimates are based on information provided to us by a prospective patient. We cannot predict or estimate for changes in treatment decisions, unforeseen complications, and additional tests or procedures ordered by a physician, among other variables. If you have a question please call our Pricing team at (833) 634-6306.
Mission Health makes no guarantees regarding the accuracy of the pricing information provided herein. The pricing information provided by this website is strictly an estimate of prices, and Mission Health cannot guarantee the accuracy of any estimates. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures and non-hospital related charges, any of which may increase the ultimate pricing for the services provided. Any prospective patient should understand that a final bill for services rendered at Mission Health may differ substantially from the information provided by this website.