Financial Services, Pricing Transparency, No Surprises Act, and Charity Care

Price Transparency

 

Beginning January 1, 2019, the U.S. Department of Health & Human Services along with Centers for Medicare & Medicaid Services require hospitals to provide standard charges. This information is limited charge data only. The information provides minimal information when understanding what your final out-of-pocket cost will be.

 

For more information regarding charges, contact us at 320.289.1580.

Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it. Starting January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways:

 

  1. A comprehensive machine-readable file with all items and services.

  2. A display of shoppable services in a consumer-friendly format.

This information will make it easier for consumers to shop and compare prices across hospitals and estimate the cost of care before going to the hospital. Information is based on contractual rates. Please review your insurance plan for coverage prior to scheduling services.

For more information regarding pricing, contact us at 320.289.1580.

No Surprises Act

 

Centers for Medicare & Medicaid Services (CMS) has instituted regulations to protect patients from surprise medical bills. More details on the No Surprises Act can be found at

 

The No Surprises Act protects patients with insurance through an employer, individual health plan or Health Insurance Marketplace from balance billing for designated services. Details of these balance billing protections can be found in this

Patients that do not have insurance or choose not to file a claim with insurance will be provided a                                         for pre-scheduled appointments. 

Charity Care

Appleton Area Heath uses the Federal Poverty Income Guideline for the initial framework of Charity Care eligibility.  Patients must apply for Medical Assistance with the county prior to applying for Charity Care.  If qualified, the balance will be discounted or adjusted in full based on the sliding fee schedule.

 

For more information regarding Financial Assistance Options, contact us at 320.289.1580.

Transparency in Coverage

 

The link below includes a Table of Contents (ToC) file in .JSON format unique to Appleton Area Health.

These files must be opened using a specialized .JSON file reader. If a .JSON file is opened using a standard business application (such as Microsoft Word), the file contents will appear as a large series of alphanumeric characters (similar to .HTML code) that will not be able to be clearly read or understood.

These files are meant to be used by researchers, government entities, and data aggregators to develop comparative data across health insurance issuers. They are not intended for use by health plan members, employees, or non-technical business users.