Price Transparency Information for Medical Services
Our Patient Financial Services department is available to answer any questions you may have about the cost of an upcoming procedure, test or admission.
BEFORE YOUR HOSPITAL PROCEDURE / STAY
Valley Regional Healthcare can help you better understand and plan for any out-of-pocket health care costs by providing our patients with information on costs for an upcoming service or procedure.
Please note that prices offered are estimates only – procedure costs will vary based on your specific circumstances including health insurance status and changes in coverage; length of time spent in the hospital; additional tests or procedures ordered by your physician; or any unforeseen conditions or circumstances surrounding your care or recovery.
If you have health insurance and would like a price estimate, please contact your insurance provider by calling the telephone number on the back of your health insurance member card or by visiting their website. The Affordable Care Act requires health insurance companies to provide pricing information to their customers, including both the hospital portion as well as the physician services. You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost – learn more about the “Good Faith Estimate” .here
If you don’t have health insurance and would like to receive an estimate of your financial responsibility for an upcoming service or procedure, please call us at (603) 543-5693, and we can help determine the estimated cost of an upcoming service or procedure.
To help us better serve you, please feel free to download and use the Consumer Checklist, which identifies some of the information that we’ll need to provide you with a price estimate. Price estimates provided by Valley Regional Healthcare will represent the hospital portion of your medical bill only – physician services are billed directly from the physician name.
KNOW YOUR INSURANCE COVERAGE
If you have health insurance and would like a price estimate, there are steps you can take to understand your insurance coverage and protect yourself from surprise bills. Your insurance company can answer questions about your coverage and anticipated costs. You can contact your insurance provider by calling the telephone number on the back of your health insurance member card or by visiting their website.
Based on your insurance plan, you may be billed for deductibles, co-payments or co-insurance for your procedure or medical care. All covered services will be billed directly to your insurance company. Below are some questions you can ask that will help you in determining your healthcare costs:
- Ask your insurance company whether you need a pre-authorization or a referral before
scheduling the procedure at the hospital
- Ask your physician for the Current Procedure Terminology Code (CPT Code) or specific procedure descriptions – and then ask your insurance company if it is covered by your plan
- Ask your insurance company if the hospital is in-network with your insurance plan
- Ask the hospital if any additional tests will be ordered, or if there will be any additional physicians who will be taking care of you during your procedure / hospital stay. These might include surgical, anesthesiology, pathology, radiology, etc.
- Ask your insurance company for an estimate of out-of-pocket costs – this may include a copayment, deductible or co-insurance costs.
The Affordable Care Act requires health insurance companies to provide pricing information to their customers, including both the hospital portion as well as the physician services.
In-Network vs. Out-of-Network
Valley Regional Healthcare does not participate in-network with all insurance plans. If you receive care from an out-of-network hospital or physician it could increase your out-of-pocket costs. To verify your out-of-network services, contact your insurance company directly by calling the number listed on the back of your insurance card.
If you need assistance paying for your healthcare services, please contact us to learn more about our financial assistance programs and payment plans available to you.
IF YOU ARE UNINSURED
Valley Regional Healthcare provides care to everyone who needs it, regardless of their insurance status or ability to pay. If you don’t have insurance coverage, we can provide you with information on available insurance options, eligibility requirements and applying for health insurance coverage. In addition, Valley Regional Healthcare provides discounts for those without insurance – contact our financial counselor at (603) 543-5693.
If you leave a message, please speak slowly and provide your full name (with spelling), date of birth, daytime and evening phone numbers, and tell us briefly about your question or concern. Our staff will return your call within 24 business hours.
If you don’t have health insurance and would like to receive an estimate of your financial responsibility for an upcoming service or procedure, please call us and we can help determine the estimated out-of-pocket costs.
UNDERSTANDING YOUR HOSPITAL BILL
Hospitals should provide information on billing and what to expect after their procedure or service, to help eliminate questions that might arise given that the billing process can be very confusing to patients – especially when why patients may get more than one bill for the same service.
After your procedure or discharge from the hospital, you will receive a hospital bill for services and care you received from the hospital during your procedure or stay. You may receive separate bills from your own physician, or from other physicians that provided care / services during your procedure or hospital stay.
If you have health insurance, we will bill your insurance company directly – you will see a summary of services billed directly to your insurance on your hospital bill.
You will receive an Explanation of Benefits from your insurance company which will explain what it paid the hospital for your care, or what it declines to pay. You may receive a bill for expenses not covered by your insurance company, such as co-pays, deductibles or co-insurance.
If you have any questions about your hospital bill, please contact us.
Our staff are available Monday through Friday from 8:00 AM to 4:30 PM