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 making price transparency available through on line self -service access, as well as through telephonic and in person service support. 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. In addition to complying with regulatory requirements, UH continues to optimize solutions and communication regarding transparency through the patient’s financial journey.

The price you pay for a healthcare service depends on your insurance or financial options as uninsured patients qualify for those programs. If you have insurance, the benefit plan you selected and your insurance plan carrier share your healthcare costs. Your financial responsibility will vary depending on the specifics of your insurance coverage. Factors that determine how much you will pay, and how much your insurance plan pays, may include network eligibility of the hospital and providers you choose, site of service 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, hospital 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 hospital cost for medical services by using our hospital price estimation tool or 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 who contact Financial Counseling will be quoted an estimated amount that includes cost for UH hospital and UH professional services including unmet deductible, as well as co-pay or co-insurance amounts due as established by the health insurance plan. Self Service/on-line estimates provide hospital costs for care and do not include the professional services associated with their procedure.

Estimates will not include any services related to complications, additional services and/or changes to original services that may occur during the episode of care. Also, charges for services provided by non-UH physicians, such as a surgeon, pathologist, or anesthesiologist will not be included in your estimate. These charges will be billed separately by the specific provider.

Beginning January of 2021, CMS required hospitals to post the payer specific negotiated charges for a list of the top 300 shoppable services, or provide patients with a price estimator tool. UH has chosen to provide patients with a hospital price estimation tool. To receive an estimate for services at UH Lake West Medical Center, UH TriPoint Medical Center or UH Beachwood Medical Center, start here. CMS also required hospitals to provide a machine readable file of payer negotiated charges, de-identified maximum and minimum payer negotiated charges and the discounted cash charges. To access this set of charges, please access the links under “Machine Readable File” below.

*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.