Important information Regarding Use and Limitations of Current Standard Charges Document and Patient Liability Estimator
To obtain the most accurate estimate of the patient out of pocket costs, Moab Regional Hospital (MRH) strongly recommends that patients contact their insurance provider or contact a Financial Navigator at Moab Regional Hospital, 435-719-3542, to request an estimate. To obtain the most accurate estimate, MRH will need patient’s insurance information and specific description of the services to be rendered, a physician’s order is preferred.
The charges listed in the Current Standard Charges document or the Patient Liability Estimator Tool may not represent the actual cost that insurance and/or patient may be responsible for.
The actual cost to insurance and/or patient, as well as the out-of-pocket amount which a patient will be directly responsible, are determined by several factors and are not in the exclusive control of MRH, including, but not limited to:
- The payment methodology applied by the patient’s insurance, which may include commercial health insurance, automobile insurance, worker’s compensation insurance, or government health insurance coverage, e.g. such as Medicare, Medicaid, or Veteran’s Administration, etc.
- The patient’s level of coverage, particular insurance plan (e.g. HMO, PPO, etc.) network participation status with the hospital and its providers, and the patient’s current outstanding benefits within the patient’s plan, including co-pays, co-insurance, remaining deductible, and out-of-pocket maximum.
- The most appropriate services, as determined by the patient’s treating and/or referring physician(s) at the time they receive the services, and acknowledging that the patient’s actual medical need, as determined by the treating physician at the time of service, maybe substantially different than the anticipated medical need prior to provision of the medical treatment or services.
- Although estimates are available for most scheduled services, the nature of healthcare, including the factors described above, dictates that the appropriate level of care, and thus the patient out-of-pocket cost of that care, frequently cannot be accurately determined until the care has actually been provided.
- The actual cost for which the insurance and/or patient may be responsible are often, although not always, less than the total charges posted to a patient’s account, and thus, estimating payer cost or patient out-of-pocket responsibility using Current Standard Charges document or Patient Liability Estimator alone will not produce the most accurate estimate.
- Patients without insurance coverage are eligible for a minimum of a 39% discount off of current standard charges at MRH. However, depending on the type of service received, the timing of payment, and patient’s financial need, prompt payment discounts, or potential financial aid, patient’s actual out-of-pocket expenses may be even lower.