What Will This Cost?  

By: Leah Hollenberger

Buying healthcare isn’t like shopping for clothes or groceries. The question ‘What will this cost?’ is not easily answered, particularly for inpatient stays and outpatient procedures. The answer can be difficult because charges vary by hospital. They vary due to the types of services each hospital provides and the mix of patients it sees. It is also complicated by how our healthcare reimbursement system operates.

So what can you do? The best way to find out what the hospital will charge for a proposed treatment or test is to contact the hospital’s Patient Financial Department or the Billing Department. They’ll ask for information about the proposed treatment or test and will be able to provide you with an estimate of what will be charged. They can also help you determine how much deductible, co-pay, and any amount not covered by insurance for which you may be responsible. It will be a range because every person responds differently to treatment and it is difficult to predict in advance all of the supplies and services you may end up receiving. The other thing to remember is that everyone is charged the same price but most people do not pay the full amount because they are covered by Medicare, Medicaid, or private insurance. Hospitals also offer financial assistance and the financial counselor/billing staff can help you apply for assistance and/or help you set up a payment plan. At Copley, you can reach our patient financial counselors at 888-8336.

Another tool is the Vermont Hospital Report Card on the Vermont Department of Health’s website: http://healthvermont.gov/health-statistics-vital-records/health-care-systems-reporting/hospital-report-cards. Here you can compare the average charge for inpatient stays, outpatient procedures, and charges for common outpatient services and visits. Be aware that the most current data is for Outpatient Services and Visits; it is from 2017. The data for Inpatient Stays and Outpatient Procedures is from 2015; it lags a few years because they are based on claims data and it takes time to aggregate the group of charges that make up the overall cost for a specific type of inpatient stay or outpatient procedure.

Hospital rates change each year, so if you are seeking an estimate for an inpatient stay or outpatient procedure, you may want to contact the hospital’s billing office to get a more up-to-date estimate.

Price is but one factor when considering where to go for your healthcare services. Other factors that people consider is the relationship they have with their doctor, quality measures such as rate of successful outcomes and infection control, transportation, and how easy it is for family and friends to visit or assist. All of these factors are important when considering healthcare. The best thing about considering all of these factors is that it means you are an informed patient taking an active part in making the right choice for you.

Leah Hollenberger is the Vice President of Marketing, Development, and Community Relations for Copley Hospital. A former award-winning TV and Radio producer, she is the mother of two and lives in Morrisville. Her free time is spent volunteering, cooking, playing outdoors, and producing textile arts. Leah writes about community events, preventive care, and assorted ideas to help one make healthy choices.