Patient Financial Resources (2024)

What factors should I consider when comparing hospitals?

The cost of your health care is important, but cost shouldn’t be your only consideration. It is important to consider many factors when choosing a health care provider and facility. Those factors include quality of care, patient safety, access to specialists, availability of clinical trials of the latest treatments, and use of cutting-edge technology.

What does the posted list of standard charges tell me about the cost of my health care?

As required by the Centers for Medicare and Medicaid Services (CMS), UI Health Care publishes a complete list of standard charges. However, it is important for you to know that this charge document does not contain any information about your personal out-of-pocket cost for your treatment. Your actual out-of-pocket costs, including any copays or deductible amounts, will vary depending on the health insurance policy you selected and whether or how it covers the treatment you are seeking. The charge document is also not helpful if you qualify for financial assistance or other types of discounts or accommodations.

It is important to understand the difference between two types of charges common in the health care industry. The first type is “gross charge” or “standard charge,” which is the established price that is billed to all patients regardless of any insurance or health care coverage. The second type is “negotiated charge” or “contracted rate,” which is the price that insurance companies and payers have agreed to pay for services. In the vast majority of cases, hospitals and physicians are reimbursed by insurance companies and payers at a rate that is considerably less than the amount charged.

A patient with insurance or health care coverage is commonly responsible for a portion of the contracted rate, which will vary based on the benefits provided by the insurance companies and payers. The amount is called the out-of-pocket expense (most often a copay, deductible amount, or co-insurance).

You should talk with your insurance provider orUI Health Care Financial Counselingto understand which costs will be covered and which costs will be your responsibility.

UI Health Care believes that generating an estimate using theguest estimatefeature or through yourMyChart accountwill provide a better value in understanding your potential out-of-pocket expenses.

If you have questions regarding your cost for a specific service, please contactUI Health Care Financial Counseling. A financial counselor can provide you with an estimate and discuss any financial concerns you may have.

If you need help understanding some of the terms you read on your bill or in your health insurance policy, you can download theCMS Glossary of Health Coverage and Medical Terms, a helpful resource that uses plain language to explain commonly used terms.

How current is the information in the posted list of standard charges?

The information is subject to periodic changes. Updated information is posted to our website at least annually, following CMS guidance.

Can patients determine their out-of-pocket cost on your website?

Patients and guests are able to access their individual out-of-pocket costs for more than 300 shoppable services by usingthe price estimator tool in MyChart. The individual out-of-pocket cost may be obtained for all other services by contacting ourfinancial counseling teamor your insurance company.

Why does UI Health Care include professional fees along with a facility rate in its bills?

CMS requires hospitals that directly employ physicians to post rates for professional services. This means that UI Health Care includes the rates for nearly all services provided as part of a patient’s care. This also allows for a comprehensive estimate that shows patients their total out-of-pocket expenses. Other facilities may not directly employ their physicians and may not include this comprehensive information, which may not accurately reflect the total cost of care.

What are my rights and protections against surprise medical bills?

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise medical bills, also known as balance billing. In these cases, you should not be charged more than your health insurance plan’s copayments, coinsurance, or deductible.

UI Health Care does not participate in balance billing. If you think you have been wrongly billed, contact the Patient Billing Service office at1-866-393-4605or[emailprotected].

Learn more by readingYour Rights and Protections Against Surprise Medical Bills.

• Make sure Iowa Medicaid has your current contact information. Also tell them if you are pregnant.
  • Call 1-800-338-8366 or email [emailprotected]
• You will get mail about:
  • Renewing your Medicaid coverage
  • Switching Managed Care Organizations
• Fill out the Medicaid renewal packet.
  • Over the next 12 months, Medicaid will send a renewal packet to your home mailbox.
  • You Have 60 days (about 2 months) to fill it out. Mail it back to Iowa DHS or bring the filled out form to your local DHS office.
  • Look for your renewal due date on your packet.
  • If you have questions about when renewal will happen, call 1-800-338-8366
• Check your mailbox often.
  • Medicaid might ask for more information to renew or stop your coverage.
  • If this happens, send back the information right away.
  • Once Medicaid gets your renewal packet, they will send a Notice of Action. It will tell you if your coverage is renewed or stopped.

• If you do not fill out your renewal packet within 60 days of its arrival, your Medicaid coverage will end the last day of the month that it is due.

• Visit Medicaid Unwind:https://hhs.iowa.gov/programs/welcome-iowa-medicaid/current-projects/medicaid-unwind
• Call Member Services at 1-800-338-8366
• Visit Johnson County DHS at 855 S. Dubuque Street, Suite 102, Iowa City, Iowa
• Find another DHS office:https://hhs.iowa.gov/about/hhs-office-locations
• If you are no longer eligible for Medicaid and need other coverage, visit:https://localhelp.healthcare.gov/