You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit
www.cms.gov/nosurprises or call 1-800-985-3059.
Kossuth Regional Health Center is committed to working with consumers, payers and policymakers on developing the best solutions for achieving price transparency goals. Our active participation in CMS rule-making process reflects a strong interest in public policies that support better health, better care and lower costs to ensure affordable, high quality, and people-centered care for all.
Helpful Definitions
Understanding health care words related to price can pose significant challenges for patients. If you ask a group of people to define what “price” is, it is likely you will get a variety of answers. Below are definitions to help patients understand the terms used in the price estimate information:
Price Transparency
At Kossuth Regional Health Center, we support price transparency and believe it is important for you to know what out-of-pocket costs you will incur for services provided at our health care facility. We have established two easy ways for you to obtain estimate of your costs – call or click:
Call: By calling, we can give you an accurate estimate of your out-of-pocket costs for a medical service or procedure at Kossuth Regional Health Center. We will review:
- The specific service or procedure you will receive
- The physician providing the service
- Your insurance, including what you have already paid towards your deductible
Call KRHC at 515-295-2451 and speak with Patient Financial Services staff member. They are available Monday through Friday from 8 a.m. to 4:30 p.m.
Click: The information contained in this file is being provided in compliance with the Centers for Medicare and Medicaid Services (CMS) requirement [FY 2019 IPPS/LTCH PPS Final Rule; CMS-1694-F] for hospitals to post a list of their standard charges online in a machine-readable format.
By clicking to download this information you agree you have read and understand the following:
- The information contained in the file is current as of the last upload. Charge information is subject to periodic changes and the file will be updated as soon as practically possible to reflect such changes
- The file contains both the charge amount and the charge description of the item or service as reflected in the hospital’s chargemaster (CDM)
- A charge represents the dollar amount assigned to specific medical services before application of any negotiated discounts to third-party payers. The actual hospital charges will vary based on the type of care provided, treatments, individual health conditions and other factors. If you need an exact estimateof your out-of-pocket cost, please call us at the phone number listed above. PLEASE NOTE THESE CHARGES do not include fees from your surgeon, anesthesiologist or other professional services billed by the physician AND OTHER PROFESSIONAL PROVIDERS. Typically, you will be billed separately for these professional services
- Following the CMS guidelines, the information in this file represents the hospitals current standard charges as reflected in the CDM. However, it is important to understand that the information represented in the CDM is the starting point in many cases and can undergo additional adjustments through the billing process, therefore, please be aware:
- The charge shown is the original charge for the item or service prior to any adjustments that result from applying modifiers in certain situations
- The CDM is used in multiple hospital departments and may have different charges for the same item or service and such instances will repeat in the file. For a single chargemaster item, the charge is consistent; however, there may be slight variation in charges for services with similar descriptions for various reasons
- Charges for certain items or services are based on per unit, such as – including but not limited to – surgeries, anesthesia, and recovery which can be based on the unit of time and complexity; medications, drugs which can be based on weight-based dosage, age or packaging; etc.
- Certain items and or services have a zero dollar price in the CDM for a variety of reasons – contracted billing services that drop charges externally, no cost supplies, Investigational device or medication exemption items in clinical trials and studies, replacement for a recalled or defective device, explode codes and other system limitations. Such items and services will appear with zero dollar and is not reflective of the actual charge. In addition, items and or services are sometimes assigned a one penny price to reflect, for example, a state provided medication or drug, contrast items, therapy status codes used for CMS reporting, etc. and Is not reflective of the actual charge contained outside of the chargemaster
- The file may also contain CDM items for non-charges (such as payments, allowances, transactions, etc.)
- The file is voluminous and download may take excessive time depending on your internet speed.
By clicking to download this information you agree you have read and understand the above.
Rates for KRHC’s self-funded health insurance plan administered by Wellmark for employees and their beneficiaries can be found here.
