Understanding Billing and Charges at Colorado Plains Medical Center
Colorado Plains Medical Center is committed to helping you understand and prepare for potential out-of-pocket costs related to medical services you or a loved one may receive at our facility.
As required by federal CMS, we have posted our chargemaster for hospital services in a machine-readable format. This can be viewed by clicking this link.
As required by the State of Colorado, we have outlined the undiscounted prices for our most utilized services. These inpatient and outpatient prices can be viewed by clicking this link.
Please note that the prices listed are only estimates and not necessarily relective of a patient's actual charges or financial responsibility. The final amount a patient is charged depends on a variety of circumstances such as length of stay in the hospital, specific equipment needed for care, additional testing required to assess a condition, and unexpected complications.
An individual's financial responsibility is dependent on many factors, including if he or she is insured, under which insurer and plan he or she is covered, and if he or she qualifies for appropriate discounts from the facility.
If you are covered by health insurance, we strongly encourage you to consult with your health insurer to determine your financial responsibility for a particular healthcare service provided at Colorado Plains Medical Center. If you do not have health insurance, you may contact our Benefits Advisor at 970-542-4413 to discuss payment options prior to receividng any services from our hospital since posted prices may not reflect your actual financial responsibility.
COMMON QUESTIONS RELATED TO BILLING AND CHARGES
Where can I find out how much a service is going to cost?
You can find a list of prices for Colorado Plains Medical Center's most utilized services on our website. Please note that these prices are estimates and do not necessarily reflect a patient's actual charges or financial responsibility, which can vary significantly based on the care and services an indivdiual requires, if he or she is insured, and by which insurer or plan he or she is covered.
We strongly encourage all insured patients to consult with their health plan provider to determine their financial responsibility for a particular healthcare service provided at our hospital. We strongly encourage anyone not covered by health insurance to contact our Benefits Advisor at 970-542-4413 to discuss payment optons prior to receiving any services from our hospital.
Are these prices what I will have to pay for a service?
No. The figures we have listed on our website are base, undiscounted prices. They are only estimates and do not necessarily reflect a patient's actual charges or financial responsibility, which can vary significantly based on the care and services an individual requires, if he or she is insured, and by which insurer or plan he or she is covered.
Why can't you provide actual charges or out-of-pocket costs for patients?
Charges and out-of-pocket costs vary a lot from person to person and are difficult for us to estimate. Any charges that a patient incurs are dependent on a variety of factors such as how long he or she has to stay in the hospital, unexpected complications that may arise, specific equipment needed for his or her care, and additional testing required to assess his or her condition. One patient's needs may be vastly different from another's even though they come to the hospital for the same procedure.
A person's financial responsibility - or "out-of-pocket costs" - is dependent on many factors, including if he or she is insured, by which insurer and under which plan he or she is covered, and if he or she qualifies for appropriate discounts from our facility. Because this varies so much from individual to individual, we cannot make blanket statements about out-of-pocket costs.
We encourage all of our insured patients to consult with their health plan provider to determine their finanical responsibility for a particular healthcare service provided at our hospital.
We strongly encourage anyone not covered by health insurance to contact our Benefits Advisor at 970-542-4413 to discuss payment options prior to receiving any services from our hospital.
How does a provider set its prices?
Healthcare providers' prices are based on the cost of the service (i.e. equipment and supplies, personnel, etc.), prices charged by competitors, and prices of similar services offered. Hospital prices are set to take into account the expected mix of patients seen and reflect expected payments from varied payers. In addition, they are typically set to achieve an overall small positive margin, so a facility can keep up with community needs, investing in its services and facility, providing care for those who can't pay, and collaborating with and supporting organizations that share its mission.
Why do providers have different prices? Shouldn't one service cost about the same from one facility to the next?
Prices vary because all providers are different. Size, staffing, technology and equipment, services offered, the intensity of care provided, patients served, and many other factors all impact how much money a provider organization needs to operate - and how much it charges for services.
Why are your prices higher for some procedures than other providers?
Colorado Plains Medical Center sets its prices to ensure we can continue to be a trusted and sustainable partner for the Fort Morgan community now and into the future. Our prices help us meet the unique demands of our patients and community and allow us to invest in our employees, physicians, our facility, new technology, and most of all, delivering high-quality healthcare in the place we call home.
Do you have any plans to change your prices to bring higher charges more in line with others regionally?
We regularly analyze our charges and consider adjustments as appropriate.
Do higher prices at CPMC mean that its patients pay more for care?
The figures we have listed on our website are base, undiscounted prices. They are estimates and do not necessarily reflect a patient's actual charges or finanical responsibility, which can vary significantly based on the care an individual requires, if he or she is insured, and by which insurer or plan he or she is covered.
What are you doing to help patients reduce or better manage their out-of-pocket costs?
As you can imagine, we are subject to many legal and regulatory restrictions when it comes to patient costs, but we are offering what programs, payment options, and discounts that we can. A few of these options now include:
- A benefits advisor to help explain the complexities of the healthcare benefits system for patients
- A prompt pay discount
- Two finacing options with interest-free borrowing arrangements
- The sponsoring of an annual health fair where several free or low-cost screenings are available along with helpful information about area health and wellness services
- Negotiating with outside partner agencies to bring them in-network
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