Trinity Health Public Policy and Federal Advocacy is committed to working with consumers, payers and policymakers on developing the best solutions for achieving price transparency goals. Our active participation in CMS rule-making process reflects a strong interest in public policies that support better health, better care and lower costs to ensure affordable, high quality, and people-centered care for all. Please click here for a copy of Trinity Health Price Transparency policy card.
We support price transparency and believe it is important for you to know what out-of-pocket costs you will incur for services provided at St. Mary’s Good Samaritan Hospital. We have established two easy ways for you to obtain estimate of your costs – call or email:
Call or Email: By calling or emailing, we can give you an accurate estimate of your out-of-pocket costs for a medical service or procedure at St. Mary’s Good Samaritan Hospital. We review:
- the specific service or procedure you will receive
- the physician providing the service
- your insurance, including what you have already paid towards your deductible
Call: (706) 453-5032
Understanding health care terminology around price poses significant challenges for patients. If you ask a group of people to define what “price” is, it is likely you will get a variety of answers. Below are definitions to help frame understanding on this issue:
Charge: The dollar amount assigned to specific medical services before negotiating any discounts from payers. The charge is different from the price. Very few patients pay the charge regardless of their insurance status; and, therefore, this data is not meaningful to people.
Price: The negotiated and contracted amount to be paid to providers by payers (also called the “allowed amount”). A patient’s out-of-pocket liability for health care services is based on this allowed amount. Note that the price for a given service varies by insurance plan as these are separately negotiated by plan/employer.
Out-of-Pocket: Portion of the price for medical services and treatment for which the patient is responsible. This includes copayments, coinsurance, and deductibles.
Cost: The definition depends on the cost being referenced: To the provider, cost is the expense incurred to provide health care to patients. To the employer, cost is the expense related to providing health benefits. To the insurance plan, cost is the price paid to the provider. To the patient, cost is the out-of-pocket fees.
The information contained in this file is being provided in compliance with the Centers for Medicare and Medicaid Services (CMS) requirement [FY 2019 IPPS/LTCH PPS Final Rule; CMS-1694-F] for hospitals to post a list of their standard charges online in a machine-readable format.
By clicking to download this information you agree you have read and understand the following:
- The information contained in the file is current as of the last upload. Charge information is subject to periodic changes and the file will be updated as soon as practically possible to reflect such changes
- The file contains both the charge amount and the charge description of the item or service as reflected in the hospital’s chargemaster (CDM)
- A charge represents the dollar amount assigned to specific medical services before application of any negotiated discounts to third-party payers. The actual hospital charges will vary based on the type of care provided, treatments, individual health conditions and other factors. If you need an exact estimate of your out-of-pocket cost, please call or submit a request online as described elsewhere on this website. PLEASE NOTE THESE CHARGES do not include fees from your surgeon, anesthesiologist or other professional services billed by the physician AND OTHER PROFESSIONAL PROVIDERS. Typically, you will be billed separately for these professional services
- Following the CMS guidelines, the information in this file represents the hospitals current standard charges as reflected in the CDM. However, it is important to understand that the information represented in the CDM is the starting point in many cases and can undergo additional adjustments through the billing process, therefore, please be aware:
- The charge shown is the original charge for the item or service prior to any adjustments that result from applying modifiers in certain situations
- The CDM is used in multiple hospital departments and may have different charges for the same item or service and such instances will repeat in the file. For a single chargemaster item, the charge is consistent; however, there may be slight variation in charges for services with similar descriptions for various reasons
- Charges for certain items or services are based on per unit, such as – including but not limited to – surgeries, anesthesia, and recovery which can be based on the unit of time and complexity; medications, drugs which can be based on weight-based dosage, age or packaging; etc.
- Certain items and or services have a zero dollar price in the CDM for a variety of reasons – contracted billing services that drop charges externally, no cost supplies, Investigational device or medication exemption items in clinical trials and studies, replacement for a recalled or defective device, explode codes and other system limitations. Such items and services will appear with zero dollar and is not reflective of the actual charge. In addition, items and or services are sometimes assigned a one penny price to reflect, for example, a state provided medication or drug, contrast items, therapy status codes used for CMS reporting, etc. and Is not reflective of the actual charge contained outside of the chargemaster
- The file may also contain CDM items for non-charges (such as payments, allowances, transactions, etc.)
- The file is voluminous and download may take excessive time depending on your internet speed
By clicking to download this information you agree you have read and understand the above.