Pricing Transparency Documents Last Updated: April 15, 2024
Pricing transparency is our goal and the pricing information provided by this website is strictly an estimate of prices, and St. Michael’s Elite Hospital cannot guarantee the accuracy of any estimates. Pricing estimates may vary from patient to patient due to unforeseen complications, the number of tests or procedures performed, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Prospective patients should understand that a final bill for services rendered at St. Michael’s Elite Hospital may differ from the information provided by this website.
What is Pricing Transparency?
Each hospital must make public on the internet a list of the hospital’s standard charges for items and services provided by the hospital. In addition, hospitals are required to provide a searchable consumer friendly display of the most common “shoppable services” that could be utilized for cost estimates to help consumers make more informed decisions.
Standard Charges
St. Michael’s Elite Hospital is required to make available a Standard Charge File for consumers to review that includes the five different types of charges defined below.
- Gross Charge: The full price listed on the hospital chargemaster. Gross charges can vary from hospital to hospital for the same procedure or service based on factors like hospital location, the kinds of services the facility typically provides, and the expertise required to deliver the services.
- Discounted Cash Price: The price offered to patients who pay on their own without third-party insurance coverage.
- Payer-Specific Negotiated Charge: The charge a hospital has negotiated with a third-party payer for an item or service, which can vary based on your coverage and specific plan. You’ll sometimes see this referred to as the “allowed amount” on an insurer’s Explanation of Benefits.
- De-identified Minimum Negotiated Charge: The lowest charge a hospital has negotiated for an item or service across all insurers.
- De-identified Maximum Negotiated Charge: The highest charge a hospital has negotiated for an item or service across all insurers.
Standard Charge File Notes
- Out of Network Notice: St. Michael’s Elite Hospital is out of network with all third-party insurers and does not have Payer-Specific Negotiated Charges, De-identified Minimum or Maximum Negotiated Charges. To learn more about St. Michael’s Elite Hospital’s out of network billing practices, visit our No Surprise Billing page.
- The hospital offers discounted bundled cash pay prices instead of discounts by individual procedure.
- The hospital charges listed do not include patient-specific insurance deductibles or copayments, potential self-pay, or financial assistance discounts and therefore are not a reflection of patient responsibility.
- Actual reimbursement for services is dependent on many factors. Rates are based upon the specific facts and circumstances of the care provided to an individual patient. These may include, among other things, (1) the patient’s length of stay, (2) the severity of illness, (3) other items and services furnished to the patient (i.e., drugs and implants that vary by the product used), and (4) the overall cost of a stay.
- Pricing does not include charges for all physician services or other ancillary professional services that may be rendered during your visit.
- Not all services listed in this file may be currently available at the hospital.
If you have insurance coverage, we encourage you to contact your insurance provider to discuss patient payment obligations as defined under your insurance plan.
Shoppable Service Cost Estimates
Hospitals are required to provide a consumer-friendly display of the most common “shoppable services” that can provide you with cost estimates for specific services to support you in making informed decisions about your care and its cost. CMS wants you to be able to price shop for a specific hospital service and schedule it at a time that is convenient for you.
We support all efforts to improve your health care shopping experience and to provide cost estimates for services that inform your decision making. However, please note this is an ESTIMATE ONLY. If you proceed with a service at our hospital, you may be given a new estimate with more accurate costs and out of pocket information.
Information about our shoppable services and cash prices can be found by clicking the link below.
For more information about the services available in our hospital, please contact a patient services representative at (281) 980-4357.