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Hospital Price Transparency

Piedmont Healthcare is committed to empowering our patients, in partnership with their care team, to make informed decisions about their healthcare. This includes helping our patients understand the cost of their care, as well as financial assistance that may be available.
 

Price Estimation Tool

Piedmont Healthcare is committed to empowering our patients, in partnership with their care team, to make informed decisions about their healthcare. This includes helping our patients understand the cost of their care, as well as financial assistance that may be available.

As part of this commitment, we provide patients (and potential patients) an online tool to estimate their out-of-pocket costs for common medical procedures and tests. Our online tool calculates the out-of-pocket hospital costs based on the selected procedure and a patient’s insurance information. The online tool can also be used to estimate cost for patients that do not have health insurance coverage.

At Piedmont, we understand that healthcare costs can be very confusing, and we want to ensure our patients understand potential costs as clearly as possible. In addition to utilizing our online estimation tool, we encourage patients to contact us at 1-855-788-1212. Our Patient Financial Care team is standing by to educate patients regarding costs and billing.

It’s important to understand the online tool only provides an estimate and is not a guarantee of total costs. Please review the disclaimers in detail before using the tool.

Access the Price Estimator Tool

 

List of Standard Charges

In compliance with the Centers for Medicare and Medicaid Services (CMS) Hospital Price Transparency regulations, Piedmont provides a list of standard charges in a machine-readable format. The public may view these requirements at the following CMS webpage: cms.gov/hospital-price-transparency.

The charges posted on our website are accurate, with applicable disclaimers, as of the dates indicated within the files. CMS requires hospitals to update annually. Therefore, ongoing additions and changes may not be reflected in the posted files.

The listed charge of a hospital service is not equivalent to the actual amount paid by governmental or commercial insurance companies.  Accordingly, each patient’s financial responsibility may vary. The amount a patient pays is based on many factors, including health insurance provider, specific benefit plans and other applicable discounts, as well as the services provided based on each patient’s unique needs.

Piedmont reviews its hospital charges annually to ensure they accurately reflect the high-quality care we seek to provide. In some cases, our charges are different from other providers when we offer a differing level of care or unique clinical expertise. Overall, Piedmont works with patients, providers and partners to lower the cost of care through wellness programs, disease management and quality care.

 

Disclaimer

The comprehensive, machine-readable files below are posted to comply with federal regulations. Due to the nature of the files, they will likely be of limited utility to any specific patient.

To best understand your estimated out-of-pocket costs, it’s important for you to understand your insurance plan benefits and coverage before seeking medical care. Any amount not covered by your plan becomes your financial responsibility or the responsibility of a guarantor (such as a parent of a minor child).

The self-service Price Estimation Tool can help you and other consumers obtain cost estimates for many common services provided by Piedmont hospitals. For more specific cost estimates, please call 1-855-788-1212, to speak with a representative from our Patient Financial Care team.

To obtain the most accurate estimate, please consult with your physician to obtain the procedure codes that will be related to your treatment. This information will allow Piedmont to provide you with a service-specific hospital price estimate based on your individual circumstances and patient responsibility.

Piedmont Healthcare is using Epic’s standard output as the content for most of the facility-specific machine-readable standard charges files. Epic is a third-party information system for patient billing, which houses payer contract information.

Due to limitations in presenting complicated and differing contracted rate methodologies in a standardized way, the contracted rate (i.e., payer-specific negotiated charges) in the machine-readable files may not always reflect the contracted rate that applies in an individual patient’s case.

There are several potential variables that exist by patient and/or health insurance plan that must be considered to arrive at contracted rates applicable for specific items and services. Please read below for an explanation of each of the differing variables.

If there is a discrepancy between a payer-specific negotiated charge listed in the machine-readable file(s) and the contracted rate applicable to a specific patient claim, the terms of the payer contract will control, so the machine-readable file(s) may be of limited benefit to our patients. We recommend Piedmont patients use our Price Estimation tool for personalized cost estimates for Piedmont hospital services.

Accessing any of these posted files constitutes your agreement that you have read the above content and any additional supplementary disclaimers contained below.

Examples of potential contracted rate differences include but are not limited to the following:

 

 

Standard Charge Files

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