We can provide you with a no-cost estimate for a wide range of health services. Your estimate will include anticipated out-of-pocket costs based upon:• Your specific test, procedure or surgery• Insurance plan/coverage• Deductibles• Co-paymentsNote: Requested estimates will be provided within 5 business days
Price Estimator ToolFor commonly requested services, use our online price estimator tool (below) for an individualized out-of-pocket cost estimate.
Call us at (812) 801-0161 during regular business hours: Monday – Friday, 8:30 a.m. – 4:30 p.m. Our Business Operations Center is located at 701 Broadway in downtown Madison. A financial representative is also available inside the Hospital Entrance at the main campus, 1373 E. State Road 62.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
If you are uninsured or do not intend to use insurance to pay for scheduled non-emergency health care services, federal law requires that health care providers and facilities provide you with an estimate of the expected charges for medical items and services at least one business day before the scheduled services are to be performed. If the bill you receive is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Any patient may request an estimate of the expected charges for non-emergency health care services that have been ordered, scheduled or referred and state law requires that health care providers and facilities provide you with an estimate of the expected bill for medical items and services within 5 business days of the request.When obtaining an estimate, make sure to save a copy or take a picture of your Good Faith Estimate.
For more information about your right to a Good Faith Estimate, visit Centers for Medicare & Medicaid Services (CMS) at: cms.gov/nosurprises/consumers or call (800) 985-3059.
A Chargemaster is a file of standard charges for all items and services provided (billed) by the hospital or physician/provider office. The Chargemaster is not a helpful tool for price comparison or to obtain an out-of-pocket estimate. For information about the cost of a specific test or service, please call our Customer Service team at (812) 801-0161.
Question: How does hospital billing work?Answer: Hospital billing is complex and based on many factors, such as staffing, equipment, maintenance costs, and the differences in care needed by each patient. Additionally, hospitals are prepared with doctors, nurses and high-tech equipment around the clock for illness or injury, from a twisted ankle to a major accident. Every patient’s case is special and requires different levels of care.
Question: How are hospitals compensated for services?Answer: Hospitals are often not paid in full for the services they provide. Medicare and Medicaid generally pay less than the actual cost of caring for patients, leaving other patients to make up the difference. There are also patients who, unfortunately, can’t pay for their hospital bills. Each hospital has different proportions of Medicare, Medicaid, commercial or uninsured patients, which adds to the complicated nature of hospital billing. Every insurer, whether Medicare, Medicaid or commercial, pays the hospital differently.
Question: What are Medicare and Medicaid?Answer: If you have Medicare or Medicaid, the government sets the rates for how much is covered. Like commercial insurance, there may be some out-of-pocket costs.Medicare is a health insurance program for people age 65 or older or people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that helps with medical costs for people with low incomes.
Question: What is a charge? Answer: The amount a hospital sets for total services provided to the patient before any insurance discounts. Similar to a “sticker price,” it is usually not the final amount paid.Question: What is reimbursement?Answer: The actual amount paid to the hospital or provider by Medicare, Medicaid or other insurance.Question: What are out-of-pocket costs?Answer: The amount a patient pays to the hospital or provider (for example: deductible or co-pay).
Example of a Medicare charge breakdown: General Surgery total charge: $38,000Hospital reimbursement: Medicare: $6,800Out of pocket costs: Medicare: The 2021 Medicare deductible for an inpatient stay was $1,484In this example, the hospital will receive $8,284 for a $38,000 charge. This illustrates that the charge or “sticker price” is often not the final amount paid.
Question: What is commercial insurance?Answer: If you have commercial insurance, insurers negotiate payment rates with hospitals and providers. These rates can differ among companies, where larger insurers tend to demand bigger discounts. The demands for discounts by commercial insurance companies create further complexity for hospitals and patients to determine the true cost of any given procedure. Commercial insurers do not pay full hospital charges. Furthermore, numerous factors, such as the type of plan, co-pay amount, co-insurance amount, out-of-pocket maximums and other limitations will affect the individual’s financial responsibility to a hospital. Therefore, it is crucial that you begin by talking to your insurance company to understand all of the factors affecting your responsibility. Norton KDH Customer Service representatives can assist you. Please call (812) 801-0161 (Monday – Friday, 8:30 a.m. – 4:30 p.m.)
Question: What is self-pay?Answer: Self-pay commonly refers to patients without insurance who pay for health-related services. For patients who do not have insurance, hospitals typically offer discounts and have Financial Assistance Programs for patients who qualify and require medically necessary services. Contact a Norton KDH Customer Service Representative to learn more about available programs and options. Call (812) 801-0161.
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