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Price Transparency for Healthcare Services

Hospitals are required by law to make available information about their standard charges for the items and services they provide. This information is available for:

  • Inpatient Services & Procedures – based on MS DRG
  • Outpatient Services & Procedures – Charge Level by CPT4
  • Outpatient Ambulatory Procedures

DOWNLOAD STANDARD CHARGES PER SERVICES

Effective 1/1/2021, hospitals are required by law to disclose additional information, including:

  • Discounted cash price: The charge that applies to an individual who pays cash or cash equivalent, for a hospital item or service;
  • Payer-specific negotiated charge: The charge that a hospital has negotiated with a third party payer for an item or service;
  • De-identified minimum and maximum negotiated charges: The lowest and highest charge that a hospital has negotiated with third-party payers for an item or service;
  • Consumer Friendly Shoppable Services: an internet-based price estimator tool.

For Patients/Guests: Shoppable Services

Our consumer friendly internet-based price estimator tool is ideal for patients and guests to estimate out-of-pocket expenses for common hospital services – from labor & delivery to imaging and laboratory work, and much more. Click the button below to launch this price estimator tool.

SHOPPABLE GUEST ESTIMATES

Tip: please have your insurance information available to receive more accurate estimates.

Download disclosures here.


Price Transparency FAQs

Q: What is a hospital chargemaster?
A: The chargemaster is a comprehensive list of the services, products, and procedures provided by the hospital, including items such as supplies, prescription drugs, diagnostic tests, etc.

Q: Are the listed charges what I will pay for hospital services?
A: The charges listed are generally not the amount a patient will pay. If you have health insurance, your out-of-pocket expenses will depend on the specific services you receive, your health insurance coverage, and your insurance company’s contract with the hospital. Please contact your insurance company for more information. If you do not have health insurance, you may be eligible for: 1) reduced costs under the hospital’s Financial Assistance Policy, or 2) subsidized health insurance through programs such as Medicaid. Please contact 845-333-1888 for Garnet Health Medical Center or 845-794-3300 x2430 for Garnet Health Medical Center-Catskills for more information.

Q: Are charges the same for every patient?
A: Yes, hospital charges are standard for every patient, regardless of insurance status. The total charges on your patient bill will reflect the actual services that you receive, which may vary based on several factors, including your length of stay, the time it takes to complete your procedure, medications you receive, and other health conditions related to your care. In addition, your out-of-pocket expenses will depend on your insurance coverage and/or eligibility for discounted care based on the hospital’s Financial Assistance Policy.

Q: How can I get an estimate of my out-of-pocket expenses for a procedure?
A: Patients with health insurance should contact their insurance company to get an estimate of their out-of- pocket expenses for a procedure. The Estimate for Services (?) or Services Estimator (?) tool available on our website can also be utilized. Patients without health insurance should contact 845-333-1888 for Garnet Health Medical Center or 845-794-3300 x2430 for Garnet Health Medical Center-Catskills for an estimate, information about the hospital’s Financial Assistance Policy, and whether you may be eligible for subsidized health insurance through programs such as Medicaid.

Q: Can a patient receive a bill for services that are not included in the chargemaster?
A: Yes, the hospital chargemaster reflects hospital services only and does not include professional fees such as physician services that are billed separately. For estimated professional charges, please contact your physician’s office. In addition, the physician chargemaster is also located on our website.

Q: If insurance companies and patients without health insurance don’t pay the chargemaster prices, what do they pay?
A: Some insurance companies have contracts with the hospital and/or medical group for discounts from charges. In addition, patients with health insurance are responsible for certain cost-sharing requirements such as deductibles, copayments, and/or coinsurance which vary by insurance plan. Patients without health insurance can apply for support through the hospital to either receive insurance coverage (if eligible) or reduced costs through the hospital’s Financial Assistance Policy. These programs will reduce the amount owed by the patient. Please contact 845-333-1888 for Garnet Health Medical Center or 845-794-3300 x2430 for Garnet Health Medical Center-Catskills for more information. Keep in mind that your insurance company or plan may not be participating with every facility or medical group and therefore may not have a contract.

Q: Why do charges for the same procedure or item vary by hospital?
A: Hospitals set their standard charges for services and items based on metrics, including the cost to provide patient care – which varies between hospitals. For example, charges will vary based on the location of the hospital, the availability of specialized services such as trauma and transplant services, whether it is a teaching hospital, its level of underpayment from the Medicare and Medicaid programs, and services provided to the uninsured. Again, these listed charges are generally not what insurance companies or patients without insurance ultimately pay.