Your Best Value: Top Quality and Low Cost

As with any major purchase, people have a right to know the cost associated with a procedure or medical treatment before they make the decision to move forward with their particular care plan. Whether you have private insurance, Medicare, a health savings account or high deductible plan, the cost you incur for your health care is ultimately your responsibility. Knowing approximate costs in advance can help you make informed decisions about your care and help avoid confusion later on.

During your hospital stay, a variety of doctors and medical professionals will take care of you. Some of these providers work in the hospital, while others work in medical offices that will bill you separately. As our patient, you should expect to receive two types of bills:

• Hospital bills: Your hospital bill will only include services you received from Holland Hospital and our staff. It will include room or facility charges, certain hospital tests, etc.
• Provider bills: You will also receive separate bills from your surgeon and other professionals involved in your care. Examples include emergency medicine specialists, anesthesiologists, radiologists, pathologists and other specialists.

To stay in compliance with Medicare rules, when you see a doctor in a hospital inpatient or outpatient department, doctor and hospital charges are billed separately. However, if you see a doctor in a private office setting, all related services and expenses are usually combined into a single charge.

Prices for health services can be difficult to estimate because:

• There are differences between what hospitals charge, what insurance companies pay, and what patients are responsible for.
• Your treatment needs may not be known in advance—it's possible you may receive additional care or different care than what was expected.
• Insurance coverage varies from patient to patient, even if you have the same insurance company and type of plan.
• Your actual out-of-pocket costs depend on your specific deductibles, coinsurance and copays.

For the reasons above, Holland Hospital provides an average price that is most common for a given procedure or treatment. Since this is an average price, the cost may be lower or higher depending on your actual care. Remember, this price reflects our charges before insurance; your out-of-pocket costs after insurance will be different.

The amount you owe will depend on what your insurance plan covers. It's advisable to contact your insurer directly to determine what services, tests and procedures are covered, as well as to identify any potential out-of-pocket expenses. You should also verify that your insurance company lists Holland Hospital as an approved, "in network" provider. If not, you may still choose Holland Hospital for your care, however you may be responsible for paying a larger portion of the charges.

Please note, when you call your insurance company, you may be asked to provide a procedure code. Your doctor's office can provide you with the correct procedure code.

Holland Hospital treats all who come to us seeking care, regardless of background or ability to pay. If you're experiencing financial difficulties, we can help. Our patient financial advocates can work with you to explore monthly payment plans or other financial assistance options. We can also help you apply for Medicaid or Medicare, should you qualify.

• HELP Financial: We offer access to HELP Payment Plans, giving you up to three years to pay your Holland Hospital, Bone & Joint Center and Western Michigan Urological Associates balances

Please call our Patient Advocates at (616) 394-3626 for additional information on our financial assistance options or to be "pre-screened."

Along with your hospital bill, you will also receive bills from your surgeon, emergency room doctors, anesthesiologist and/or radiologist. If you have questions about these charges or bills, please contact:

Anesthesiology: (800) 581-9044
Radiology (diagnostic testing interpretation): (616) 363-7229
Laboratory/Pathology (other testing interpretation): (616) 594-1876
Surgery/Specialists: Will vary by your type of procedure. Contact your surgeon's or specialists' office directly. If you don't have a surgeon or specialist and need a referral, our Find A Doctor link can help you get started.

Copays, coinsurance and deductibles are the portion of the medical bill you're responsible for, otherwise known as out-of-pocket costs. Generally speaking, a deductible is a fixed dollar amount you must pay out of your own pocket before your insurance will cover remaining eligible expenses. Coinsurance is typically a percentage that represents how much you will be required to pay and how much your insurance plan will pay toward your coverable medical expenses. (Deductibles are commonly used in conjunction with coinsurance.) Similar to a deductible, a copay or copayment is a fixed amount of money you must pay each time you need to use your insurance. Copays tend to be smaller dollar amounts (e.g., the fee you pay each time you visit your primary care doctor).

For more information about your copay, coinsurance or deductible responsibilities, we recommend contacting your insurance company.

Diagnosis-Related Group (DRG) is a classification system that describes the major “products” that the hospital provides, such as a total hip/knee joint replacement or an appendectomy. These DRG codes are typically used with inpatient care to guide insurance reimbursement.

Current Procedural Terminology (CPT) codes are the standard for how medical professionals document and report medical, surgical, radiology, laboratory, anesthesiology, and evaluation and management services. These five-digit codes are typically used with outpatient care to guide insurance reimbursement.

Yes, we'd be happy to help. Holland Hospital can provide you with a written estimate of charges for any service offered at our hospital. To request an estimate, call (616) 394-3626. When you call, please be prepared to provide:

• The name of the procedure or treatment you will be having.
• Any specific CPT codes on your physician order or given to you by your provider.
• Your current insurance information.

Our Patient Financial Services experts are available to answer questions regarding your bill Monday-Friday, 8 am-4:30 pm. Simply call (616) 394-3122. You can also learn more about billing and/or pay your bill safely and securely online.