Below are four phrases critical to the hospital billing process:
The most important number is what you will have to pay. This depends on your insurance coverage, and your insurance company is your best source of information on your co-pay and deductibles. If you have no insurance, we offer discounts, charity, and payment terms.
We track Exempla's costs for each case - direct costs of supplies and staff, and allocations of support services. Our costs differ for each case, because each patient can require different treatment, even for the similar diagnoses.
We also track Exempla's payment for each case from you and from your insurance company. In some cases payments are more than our costs (most insurance companies pay higher than our costs), and in other cases payments are less than our costs (usually Medicare, Medicaid and uninsured cases).
The least important number that we track is our gross charges. Nearly all hospitals have gross charges that are much higher than costs or expected payment (sometimes two to three times higher). Gross charges are the basis upon which hospitals calculate discounts to insurers. Gross charges are like full-fare coach on airplanes: it's a price that rarely ever applies. They are also the number currently used most often to make price comparisons between different hospitals.