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Price Transparency

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Price Transparency

A simple guide to checking healthcare prices

Understanding what you will pay before a medical visit or procedure can help you plan ahead and avoid surprises. Use this quick guide to estimate your out-of-pocket cost.

 

Review your health insurance
Your personal health insurance policy determines when coverage kicks in, how costs are shared, and how much you ultimately pay. For those that have health coverage – 94 percent of North Dakotans – your out-of-pocket costs are determined by your health insurance plan and their negotiated rates, not the hospitals’ charges for a given service.

 

Use your healthcare provider’s patient portal to request price estimates
Patient portals, such as MyChart, often integrate price estimation tools with your personalized insurance on file. The result is an estimate that shows your health insurer’s contracted rates plus an estimate of your personal out-of-pocket costs.

 

Use your healthcare provider’s online price estimator tools
CMS Hospital Price Transparency rules require hospitals to publicly post their prices—including negotiated insurance rates—and to provide patients with tools to estimate the cost of care. To find this information, go to your hospital’s website and search for “price transparency.” Be sure to enter your health insurance policy information for a personalized estimate. Or use the hospital price transparency websites and contact information listed below.

 

Call your healthcare provider’s financial services office
Ask: “Can you help me get a cost estimate for [service]?” Be ready to provide the name of the test, visit, or procedure, your insurance policy number, and the location where you will receive care. Additional questions to ask: “Is this the negotiated rate with my insurance?” and “What will my personal out-of-pocket costs be?”

 

Contact your health insurance company
Use the phone number on your insurance card and ask the following:

  • “Can you help me get a cost estimate for [service]?”
  • “Please explain to me what my out-of-pocket expenses will be.” These costs include your plan’s deductible, copay, and coinsurance amounts. 
  • Ask if your cost depends upon where you get care.

 

If you are uninsured
Call your provider’s billing office and ask about self-pay discounts (which are generally lower than list prices), payment plans, and financial assistance programs. North Dakota’s non-profit hospitals provide free and discounted care to individuals whose income is as high as 400% of the federal poverty level.

North Dakota Hospital Price Transparency Contacts

Altru Health System

 

Ashley Medical Center

 

CHI Lisbon Health

 

CHI Mercy Health Valley City

 

CHI Oakes Hospital

 

CHI St. Alexius Bismarck

 

CHI St. Alexius Health Carrington

 

CHI St. Alexius Health Devils Lake

 

CHI St. Alexius Health Dickinson

 

CHI St. Alexius Health Garrison

 

CHI St. Alexius Health Turtle Lake

 

CHI St. Alexius Health Williston

 

Dakota Regional Medical Center – Cooperstown

  

Essentia Health

 

First Care Health Center – Park River

 

Heart of America Medical Center – Rugby

 

Jacobson Memorial Hospital Care Center – Elgin

 

Jamestown Regional Medical Center

 

Langdon Prairie Health

 

Linton Hospital

 

McKenzie County Healthcare Systems – Watford City

 

Mountrail County Medical Center – Stanley

 

ND State Hospital – Jamestown

 

Nelson County Health Systems – McVille

 

Northwood Deaconess Health Center

 

Pembina County Memorial Hospital -Cavalier

 

Prairie St. John’s – Fargo

 

Sakakawea Medical Center – Hazen

 

Sanford Health Bismarck, Fargo, Hillsboro, and Mayville

  

SMP Health  St. Aloisius – Harvey

 

SMP Health  St. Andrew’s – Bottineau

 

SMP Health St. Kateri – Rolla

 

South Central Health – Wishek

 

Southwest Healthcare Services, Bowman

 

St. Luke’s Medical Center, Crosby

 

Tioga Medical Center

 

Towner County Medical Center – Cando

 

Trinity Health – Kenmare and Minot

 

Unity Medical Center – Grafton

 

Vibra Hospital Central Dakotas – Mandan

 

Vibra Hospital of Fargo

 

West River Health Services – Hettinger