Hospital Price Transparency

Understanding Hospital Charges

Transparency in pricing and standard charge list

The Centers for Medicare and Medicaid Services (CMS) require all hospitals to post a list of their standard charges — a Charge Description Master — online and update it yearly. Effective January 1, 2021, CMS guidelines now require hospitals to disclose all standard charges for care for all items and services provided by the hospital. This includes:

• Gross charge
• Discounted cash prices available to patients who self-pay
• Payor-specific negotiated charges for all payors
• De-identified minimum and maximum negotiated charges

If you are scheduled for a surgical procedure or medical imaging such as an MRI, CT ultrasound of EKG, you will receive a phone call 2-7 days before your appointment from Guthrie’s pre-arrival team (570-887-6250). The purpose of this call is to review your insurance coverage and benefits, the status of approval from your insurance provider, and out-of-pocket expenses, if any. 

These calls can be helpful to you in a few ways:

• Knowing the cost ahead of time prevents surprises and can reduce worry about what to expect when your bill comes. 
• Knowing your costs can help you budget, allows you to explore payment plans or loans, and can help you make decisions when it is time to enroll for insurance in the future. 
• Our team may be able to help you enroll in insurance through your employer or Medicaid that can help with the cost of your procedure, prescriptions, medical supplies or devices.
• Discussions about financial options can save you the time of researching them yourself.