Understanding Your Cost of Care
Frequently Asked Questions

 
Price Transparency FAQs

What’s happening?

As part of a price transparency initiative, the Centers for Medicare and Medicaid Services (CMS) require hospitals to post standard charge information for procedures and services on their public websites along with providing access to price information on certain “shoppable” services. Our List of Charges includes charges that are current through the date listed on each hospital’s downloadable spreadsheet, and the regulation requires our hospitals to update this list only once per year, even though our rates may change several times per year. As a result, these lists may not contain the most current pricing, as price changes often occur.


What does the standard charge information include?

Standard charge information is listed for each Hartford HealthCare hospital and includes the charge for the service, the negotiated rate for the service, and the cash price information for hospital services. We must provide charges from a long list of services known as the “chargemaster.”


Are these the actual prices I will pay?

No. The amounts listed on the standard charge list do not necessarily show your out-of-pocket cost. Hospitals are required to list standard charges including negotiated rates as the starting point for bills for services that you may receive. You or your insurance company may be required to pay more or less than the standard charge for a particular item or service, depending on your particular insurance coverage. In addition, the new federal regulations require this list to be updated only once per year, even though our rates change multiple times per year. For up-to-date information, please contact your insurance company or your government payor, if applicable.


What portion of the charges can I expect to pay?

Insurance companies and payors such as Medicare, Medicaid, workers’ compensation, and other commercial insurance companies do not pay “charges.” They pay a set price that has been determined in advance called the “negotiated rate.” Patients with insurance typically only pay the out-of-pocket amounts (deductibles, co-pays, and/or coinsurance) set by their insurance company. Some payors do not have negotiated rates with HHC. Patients with insurance through these out-of-network payors may have higher out-of-pocket costs than those insured through an in-network payor due to their level of out-of-network benefits or responsibility for remaining balances. If you have questions on whether your insurance company has negotiated rates with HHC, please contact them directly.


Why do I see multiple fees for my service?

Certain services will incur multiple fees. The most common of these are facility or hospital fees, which are fees for services performed at a hospital or hospital-owned facility, and professional fees, the fees associated with the care provided by your provider(s).


Do the lists include all charges for a service?

No. Patients may receive separate bills for services that are not billed directly by Hartford HealthCare hospitals, or for professional services rendered by providers who are not employed by our hospitals, including, for example:

  • Anesthesiologists
  • Cardiologists
  • ER physicians
  • Hospitalists
  • Pathologists
  • Physician services
  • Radiologists

Can I get an estimate that shows my portion of the cost?

Yes. You can either use our price estimator tool or contact one of Hartford HealthCare’s financial counselors who can help by calling 860.696.6010. Please be prepared to provide the CPT or DRG code for the procedure. These codes are an alphanumeric code for your particular diagnosis, procedure, or service. Your doctor’s office can provide these codes to you. You can also contact us via email.


What assistance is available if I need help paying my medical bill?

Hartford Healthcare offers financial assistance and payment plans to assist patients with their medical bills. Please contact our financial counselors at 860.696.6010. Learn more about our financial assistance policy.


How frequently are the standard charges updated?

Standard charges are updated regularly, but the federal Price Transparency Rule requires each hospital to update its List of Charges only once per year. As a result, the List of Charges available on this page may not be the most current standard charge, and may not be applicable to past services. You should contact your insurance company, insurance plan, or government payor for the most up-to-date information about costs for your specific date(s) of service.


The standard charge for a particular item or service is listed as “N/A.” Should I assume that HHC does not offer that item or service?

No. An “N/A” designation within an HHC hospital’s List of Charges simply means that the hospital does not have a standard negotiated charge for that service. The service is likely available. The corresponding standard charge, however, may not be available because, for example, the charge may be calculated on a case-by-case basis, or using a complex methodology, or it may depend on certain factors that the hospital cannot determine in advance of the service. If you have any questions about the services or procedures offered at our hospitals, please contact us.


I do not see a particular item or service listed. Should I assume that HHC does not offer that item or service?

No. Certain services are not charged based on a specific code in the Chargemaster. For example, the CPT codes for many outpatient surgeries are based on the notes from the health care professional performing the surgery and therefore are not known ahead of time. The charge for these surgeries is based on the amount of time that the patient spends in the OR, and not a fixed amount. If you have any questions about the services or procedures offered at our hospitals, please contact us.


Does the standard charge for a particular drug, ancillary service, or supplies represent the actual amount I should expect to pay?

Not necessarily. We have listed our standard charges for pharmaceuticals and supplies as required by the federal Price Transparency Rule. However, some procedure codes may bundle together numerous charges. For example, the standard charge for a particular inpatient service may be “bundled" to already take into account certain drugs, supplies, and services (e.g., x-rays), and HHC would not then separately bill the standard charges for those drugs, supplies, or services. On the other hand, HHC may bill the standard charges for those drugs, supplies, or services if they are not included in a “bundled” standard charge. You should contact your insurance company, insurance plan, or government payor for information about which items, services, and drugs are included within a particular procedure code.

For more information regarding your cost of care