Understanding health care costs and an individual patient’s out-of-pocket costs can be difficult. We know it’s complicated, so we are here to help. Below are answers to commonly asked questions about health care costs and charges.

To help you better understand how we determine the overall cost of care and individual out-of-pocket costs, we’ve also included links to price information and patient service estimator tools. These links include the estimated costs for hospital items and services delivered at  Hill Hospital of Sumter County.

How Are Prices Determined?

Pricing for health care services and what you are ultimately charged depends on many factors. In addition to the basic pricing for the treatment or procedure you undergo at the hospital, your bill may include additional amounts for things such as anesthesia, medical equipment, facility use, lab tests, certain medications, radiology services, supplies, provider charges, and care involving unexpected conditions or complications based upon individual health at the time of service.

How Are Prices Calculated, and How Are Out-of-Pocket Costs Determined?

Pricing for services delivered by a hospital begins with the Charge Description Master, a price listing for all hospital items and services available to hospital personnel as they deliver patient care. All items and services used during the course of a patient’s treatment are summarized on a bill, which represents the total price of all items and services used during a patient’s treatment.

If a patient has health insurance coverage, hospital bills are first submitted to the insurance company for initial payment. The insurance company would pay for hospital services based on the negotiated contract with the hospital and the patient’s purchased insurance plan benefits. If the total balance was not satisfied by the insurance company, the hospital could seek payment from the patient, which would represent the patient’s out-of-pocket cost.

For patients who do not have health insurance coverage, Hill Hospital of Sumter County developed a cash price for services, including a balance adjustment similar to that experienced by a patient with purchased health insurance coverage. This adjustment seeks to provide some financial fairness for patients who do not have access to or the ability to afford purchased health insurance coverage.

Calculating out-of-pocket costs is often difficult, given all the factors that can impact a patient’s bill. The best way to find out is to ask. Thanks to current technology, Hill Hospital of Sumter County can assist with estimating out-of-pocket costs for many of our most common services. This allows patients to better understand individual out-of-pocket costs and to satisfy that responsibility prior to receiving treatment. Hill Hospital of Sumter County also recommends talking directly to your health insurance provider to better understand policy and benefit coverage and how much could be owed for a specific treatment or service.

Keep in mind that the more complex or long-term the care is, the harder it becomes to estimate costs upfront – especially if unexpected complications or other health care needs arise. Please use the links below to access the Hill Hospital of Sumter County listing of standard charges and the Shoppable File.

If you experience issues downloading any of the files above please  Contact Us for Additional Information.