Hospital charges are determined by a number of factors including insurance type, discounts, services and the hospital.
Insurance
If you are insured, your cost can differ based on the type of insurance you have both for policies purchased directly by you and those purchased through your employer. Government-sponsored insurance such as Medicare or Medicaid will also cause a difference in billing. If you are insured, you will be charged the same price for the same service as an uninsured patient. If you are insured, your insurance company with negotiate discounts with the hospital on your behalf.
If you are uninsured, you may qualify for discounts to help with the cost of your bill. For more information on discounts you may qualify for, please click here.
Patient Factors
Each patient’s cost will vary due to differences in a patient’s hospital stay and medical needs. Some examples of patient differences which affect costs are:
- Severity of illness
- Length of hospital stay
- Emergency admissions
- Differences in physicians
Each physician will vary in their procedure for treatment based on each patient’s individual needs. If a physician calls upon another physician for help in diagnosis, hospital charges may be made by more than one physician for the same patient.
Hospital Factors
Each hospital will have varying charges based on a number of factors.
Physician and Professional Fees
Physician charges, including those of surgeons, anesthesiologists and radiologists, are normally not included in hospital charges. These fees will be billed separately.
Technology
Each hospital’s technological equipment used for services varies and can affect costs. Newer technology may make costs higher.
Services
A hospital’s range and frequency of services can affect costs. A hospital which specializes in a certain service may charge more for those services. If a service is not frequently done, it may cost more to render. Some hospitals do not have a full range of services, and patients will be transferred to a secondary care facility for treatment.
Hospital Cost Structures
Hospitals differ in their approach to pricing based on operational costs. Some hospitals spread costs across all patients whereas other hospitals base pricing on specific services. Some services may cause the hospital to lose money, so it may make up for it by charging more for other services. Any of these situations can result in different charges among hospitals.
Capital Expenses
Each hospital’s debt and depreciation will be different which will affect costs to patients. A hospital with a large amount of debt, a new building or major renovation may have higher charges than a hospital not facing those expenses. Hospital leadership decisions also may affect charges in various ways.