January 1, 2021, the federal government required hospitals to provide ongoing, accessible pricing information online about the items and services they provide in two specific ways:
- A list of comparable services or a price estimator tool
- A comprehensive, machine – readable file of all “Standard Charges” for items services they provide and the rates negotiated with every insurance company it contracts with and self-pay rates.
Actual cost to the insurer and/or patient is determined by several factors and are not in the exclusive control of Littleton Regional Healthcare, including, but not limited to:
- The payment plans negotiated with individual health insurers, which may include commercial health insurance, automobile insurance, workers compensation insurance, or government health insurance coverage, e.g. such as Medicare, Medicaid, or Veterans Administration, etc.
- The patient’s level of coverage, particular insurance plan (e.g. HMO, PPO, etc.), network participation status of each provider, and the patient’s currently outstanding benefits within the patient’s plan benefit package, including co-pays, co-insurance, remaining deductible, and out-of-pocket (OOP) amount
- The most appropriate services is determined by the patient’s treating and/or referring physician(s) at the time they receive the services may be substantially different than the anticipated medical need prior to provision of the medical treatment or services.
- Although average cost is available through Littleton Regional Healthcare, the nature of healthcare, including the factors described above, dictates that the appropriate level of care, and thus patient OOP cost of that care, frequently cannot be accurately determined until the care has actually been provided.
- Patients with no insurance coverage are eligible for Littleton Regional Healthcare discount off the posted charges at Littleton Regional Healthcare; however, additional financial assistance may be available to further lower an uninsured patient’s actual OOP expenses. Patients without commercial insurance or not covered by a government health care plan should contact the hospital before a procedure to discuss charges, alternative pricing, and payment terms.