What is Pricing Transparency?
Each hospital must make public on the internet a list of the hospital’s standard charges for items and services provided by the hospital. In addition, hospitals are required to provide a searchable consumer friendly display of the most common “shoppable services” that could be utilized for cost estimates to help consumers make more informed decisions.
Standard Charges
Patients Emergency Room is required to make available a Standard Charge File for consumers to review that includes the five different types of charges defined below.
- Gross Charge: The full price listed on the hospital chargemaster. Gross charges can vary from hospital to hospital for the same procedure or service based on factors like hospital location, the kinds of services the facility typically provides, and the expertise required to deliver the services.
- Discounted Cash Price: The price offered to patients who pay on their own without third-party insurance coverage.
- Payer-Specific Negotiated Charge: The charge a hospital has negotiated with a third-party payer for an item or service, which can vary based on your coverage and specific plan. You’ll sometimes see this referred to as the “allowed amount” on an insurer’s Explanation of Benefits.
- De-identified Minimum Negotiated Charge: The lowest charge a hospital has negotiated for an item or service across all insurers.
- De-identified Maximum Negotiated Charge: The highest charge a hospital has negotiated for an item or service across all insurers.
Standard Charge File Notes
- Out of Network Notice: Patients Emergency Room is out of network with all third-party insurers and does not have Payer-Specific Negotiated Charges, De-identified Minimum or Maximum Negotiated Charges. To learn more about Patients Emergency Room’s out of network, visit the No Surprise Billing Act page.
- The hospital offers discounted bundled cash pay prices instead of discounts by individual procedure.
- The hospital charges listed do not include patient-specific insurance deductibles or copayments, potential self-pay, or financial assistance discounts and therefore are not a reflection of patient responsibility.
- Actual reimbursement for services is dependent on many factors. 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.
- Pricing does not include charges for all physician services or other ancillary professional services that may be rendered during your visit.
- Not all services listed in this file may be currently available at the hospital.
If you have insurance coverage, we encourage you to contact your insurance provider to discuss patient payment obligations as defined under your insurance plan.
Shoppable Service Cost Estimates
Hospitals are required to provide a searchable consumer-friendly display of the most common “shoppable services” that can provide you with cost estimates for specific services to support you in making informed decisions about your care and its cost. CMS wants you to be able to price shop for a specific hospital service and schedule it at a time that is convenient for you.
We support all efforts to improve your health care shopping experience and to provide cost estimates for services that inform your decision making, but our innovative neighborhood hospital does not offer any shoppable services. Instead, our neighborhood hospital focuses on emergency services and inpatient services. We don’t offer hospital-based outpatient services you can schedule in advance.
CMS defines a “shoppable service” as a hospital service that can be scheduled by you in advance. Shoppable services are typically those that are routinely provided in non-urgent situations that do not require immediate action or attention to you.
- Our hospitals only provide emergency care and inpatient services and do not offer any “shoppable” services that can be scheduled in advance.
- Because we only focus on the essential hospital services, our hospitals do not provide any opportunity for you to schedule a service at a time that is convenient for you.
- Our hospitals are open 24/7 to serve you for your emergency care and many inpatient needs, however we do not offer any shoppable services that can be scheduled in advance. Some of those “shoppable” services may be available in the same building through other services providers, unaffiliated with the hospital.
For more information about the services available in our hospital and limitations on our ability to provide shoppable services cost estimates to you at this time, please contact a patient services representative at 281-576-0555.
Pricing Transparency Last Updated: May 20, 2022
The pricing information provided by this website is strictly an estimate of prices, and Patients Emergency Room cannot guarantee the accuracy of any estimates. Pricing estimates may vary from patient to patient due to unforeseen complications, the number of tests or procedures performed, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Prospective patients should understand that a final bill for services rendered at Patients Emergency Room may differ from the information provided by this website.
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