If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill. You may do so by either contact:
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 800-985-3059.
OMB Control Number [0938-NEW]
Expiration Date [MM/DD/YYYY]
FINANCIAL ASSISTANCE PROGRAMS
In situations where a patient does not have insurance, patients may be eligible for free or reduced cost of health care services through various state public assistance programs as well as the hospital financial assistance programs (including but not limited to MassHealth, the premium assistance payment program operated by the Health Connector, the Children’s Medical Security Program, the Health Safety Net, and Medical Hardship). Such programs are intended to assist low-income patients taking into account each individual’s ability to contribute to the cost of his or her care.
For those individuals that are uninsured or underinsured, the hospital will, when requested, help them with applying for either coverage through public assistance programs or hospital financial assistance programs that may cover all or some of their unpaid hospital bills. You can find more information on our financial assistance policies page or speak to a financial counselor in our Financial Services office at 978-287-3432 between 8 a.m. and 5 p.m., Monday through Friday.
WHAT IS NOT INCLUDED IN THE STANDARD CHARGES LIST?
The hospital’s standard charges may not include prices for services provided by the doctors who treat you while you are at the hospital. You may receive separate bills from the hospital and the doctors involved in your care.
The following provides a list of providers who may send a separate bill for any services provided in the hospital:
- Your personal doctor, if he/she sees you in the hospital
- The surgeon who performs your procedure
- The anesthesiologist who works with the surgeon
- The radiologist who reads your x-rays or other imaging
- Other doctors who may be consulted by your doctor during your time in the hospital
ARE CHARGES THE SAME FOR EVERY PATIENT?
The list of charges is the same for all patients. However, methodologies for hospital reimbursement are extremely technical, with a multitude of factors that go into the amount health plans pay to providers for any given service. The total charges for an individual patient often vary from one patient to another for a number of reasons, including but not limited to:
- How long it takes to perform the service or how long it takes you to recover in the hospital
- Whether the service or procedure you receive is more or less difficult than expected
- What kinds of medication you require
- Whether you experience complications and need additional treatment
- Other health conditions you may have that may affect your care
In some cases, an insurer may have multiple products with different prices for the same service. It is therefore likely that you will see different prices for the same service, depending on which insurer you are looking at.
As mentioned above, standard charges almost never reflect your out-of-pocket costs for treatment. Those costs will depend on the exact policy you are enrolled in and how it applies to the specific care service you are seeking. This listing also does not account for any financial assistance you may qualify for, nor will it be accurate if you are uninsured or seeking treatment that is not covered by your insurance policy.
MASSACHUSETTS TRANSPARENCY WEBSITE
Through the Center for Health Information Analysis (CHIA), the state has created a website, CompareCare (www.masscomparecare.gov), for consumers to compare costs of medical procedures across the Commonwealth. CompareCare also includes quality metrics where available. Regarding the cost quotes, the CHIA website provides an estimate based on amounts paid to health care providers in previous years. To find out what your specific out of pocket costs will be, contact your health plan.