Centers for Medicare & Medicaid Services (CMS) Price Transparency Initiative
University Hospitals is committed to provide a personalized patient experience that includes our billing and collections process. We are devoted to meeting your needs by providing comprehensive service and support for you to access and communicate with our team members, who are here to support you and your family.
One of the goals of the UH patient experience is to provide price transparency. We provide a list of service descriptions and associated standard charges that complies with federal law*. These listed charges, otherwise known as a charge master**, represent gross charges for line item inpatient and outpatient services, including tests, exams, surgical procedures, room charges and more. The charges listed are not meant to reflect your patient responsibility or out-of-pocket cost that you may be expected to pay. The charge master amounts are billed to insurance and third parties, who in turn apply their contracted rates and pay according to policy coverage.
We have also published Diagnosis Related Grouper (DRG) information that contains the numeric code and associated total charges for inpatient services associated with each case. Each DRG represents the reason for the admission or procedure done during an inpatient hospital stay. An example would be DRG 470: Major Joint Replacement.
We have published charge masters that represent the hospitals within our health system. Each new community hospital that has joined University Hospitals came to our health system with its own schedule of charges and pricing. In most cases, the current charges at these hospitals are similar. As we consolidate our operations and systems, we are moving to standardize pricing across all of our UH community hospitals. We expect to have all UH community hospitals on common information technology systems before year-end 2019.
The price you pay for a healthcare service depends on your insurance. If you have insurance, you and your insurance plan share your healthcare costs. Your financial responsibility will vary depending on the specifics of your insurance coverage. Factors that determine how much of your healthcare costs you will pay, and how much your insurance plan pays, may include network eligibility of the hospital and providers you choose, and your plan’s deductible, co-payment, co-insurance and coverage limits. The amount your insurance pays to your healthcare providers is established in the plan’s contracts with in-network providers. UH has negotiated rates with all of the major insurers.
If you do not have insurance, we offer support through our financial counseling services. These services are designed to assist you with obtaining coverage, financial assistance, price estimation, payment plans and/or options to help you with your cost of care.
Patients may receive an estimate of their out-of-pocket cost for medical services by contacting the UH Financial Counseling line: 216-983-1500. Our price estimation services are designed to provide approximate financial responsibility for the procedure/services based on the average charge for the procedure/services. Patients with health insurance will be quoted an estimated amount that will be due to the hospital based on the deductible, co-pay or co-insurance amounts established by their health insurance plan.
Patients who do not have insurance will be quoted an estimated amount due to the hospital which includes an uninsured discount. Estimates will not include any services related to complications that may occur during the procedure/service. Also, charges for services provided by physicians, such as a surgeon, pathologist, anesthesiologist or radiologist, will not be included in your estimate. These charges will be billed separately by the specific provider.
|Hospital||Charge Master File||Diagnosis Related Grouper (DRG) Charges|
|UH Cleveland Medical Center
UH Seidman Cancer Center
|UH Ahuja Medical Center|
|UH Bedford Medical Center, a Campus of UH Regional Hospitals|
|UH Conneaut Medical Center|
|UH Elyria Medical Center|
|UH Geauga Medical Center|
|UH Geneva Medical Center|
|UH Parma Medical Center|
|UH Portage Medical Center|
|UH Rainbow Babies & Children's Hospital|
|UH Richmond Medical Center, a Campus of UH Regional Hospitals|
|UH Samaritan Medical Center|
|UH St. John Medical Center|
|UH Rehabilitation Hospital|
|UH Avon Rehabilitation Hospital|
*CMS/Medicare’s Price Transparency requirement as stipulated in the fiscal year 2019 Inpatient Perspective Payment System (IPPS) Hospital and Ambulatory Surgical Center (ASC) Final Rule.
**The information provided is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital, also known as a charge master. It is not a helpful tool for patients to comparison shop between hospitals or to estimate what health care services are going to cost them out of their own pocket. For more information about the cost of your care, please contact our patient financial services staff.