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Estimate Cost of Care

Healthcare Costs

There are often financial concerns involved when receiving medical care.  It can be very difficult to navigate through the medical and insurance information, and even more difficult to understand what your financial responsibility will be. Staff in the Patient Accounts office can assist you and provide a cost estimate – we want to provide you with meaningful information that helps you plan ahead.

Your health plan is a key partner in any discussion about your expected costs because these costs depend on features of your plan, where you are in your deductible and out of pocket plus the type of cost-sharing for particular procedures. You may also receive bills from other providers or labs outside of CCH. We will work with you to understand those bills to the best of our abilities; however, you may need to contact those providers directly. Estimates may also change as the course of treatment changes.

For those not covered by health insurance, our Patient Accounts office at 207-454-9211 can discuss discounts available and payment options prior to receiving services from our healthcare facilities, as posted prices may not reflect the actual amount of your financial responsibility.

Two Tools for Pricing Estimates

Researching your medical costs can be very complicated. In an effort to make pricing information accessible about procedures and services, the Centers for Medicare and Medicaid Services (CMS) has placed data sharing requirements on all hospitals around price transparency. Starting January 1, 2021, pricing information is required to be available on the website about the procedures and services provided in two formats: a downloadable file of charges and an online tool patients can use to create estimates. Final patient costs are multi-faceted, which leaves the charge information CMS is requiring to be provided as simple data files sorely lacking in accuracy.

These pieces of information should be considered additional tools or resources utilized along with the services of the Patient Accounts staff as mentioned above.  

Charge List

Every hospital has its own Charge List that is used for billing purposes. However, a hospital charge is not the same as expected payment. In most cases, what hospitals are paid is significantly less than the “charge” that is billed. Furthermore, the actual payment due from a patient will depend on the patient’s insurance coverage. CMS has required hospitals to share their Charge List, but it is not the best tool for patients to determine the cost of their health care services. The prices on the Charge List are not the actual payment rates that hospitals receive. In the vast majority of cases, hospitals are paid considerably less than the billed amount due to government payment reductions and/or negotiated rates with insurance carriers. The Charge List also does not include fees from physicians who are not employed by Calais Community Hospital, yet may provide care to CCH patients.

Click here to download the CCH Charge List file.

Online Cost Estimator

Estimates provided via the online cost estimator cannot and should not be relied on as the actual charges and/or payments you will be responsible for paying. The actual charges and/or payments may be either lower or higher than the estimates depending upon many factors – including, but not limited to, your provider’s treatment choices, actual services rendered, complications and your particular health care needs. For example, one individual may require only a one-day hospital stay for a particular procedure, while another may require a two day stay for the same procedure due to underlying medical conditions.

The estimated charges are based on the information you enter. A patient’s final responsibility is dependent on other variables as well, such as health insurance coverage and other discounts patients are sometimes eligible for.

To use the price estimator tool you will need have the following information:

~ The name of the patient’s procedure or service

~ Patient’s name and date of birth

~ Patient’s insurance policy information (if applicable)

Click here to utilize the Online Patient Responsibility Estimator resource.

Disclaimer

We are here to HELP, so please allow us to guide you to the most accurate estimate for your services. The information provided via these links is not a contract for the actual amount patients will be required to pay. Patients are held responsible for the actual amounts owed determined after services are rendered.  The estimated cost is also not a guarantee of insurance coverage. Please check with your insurance company if you need help understanding your benefits for the service chosen. THE ACTUAL AMOUNT YOU WILL BE REQUIRED TO PAY MAY BE, AND LIKELY WILL BE, DIFFERENT (HIGHER OR LOWER).