Pricing Transparency

 

Hospitals and health systems follow federal Hospital Price Transparency rules. As of January 1, 2021, hospitals are required to provide clear, accessible pricing information about the items and services they provide in two ways:

  1. Display of shoppable services in a consumer-friendly format.
  2. Comprehensive machine-readable file with all items and services.

We hope that the pricing information we have made available helps you make more informed decisions about your health.

Machine-readable file

The hospital must provide the following in a machine-readable file format:

  1. The charge is the price for an individual item or service reflected on a hospital’s chargemaster, absent any discounts.
  2. The cash amount is the charge that applies to an individual who pays cash, or cash equivalent, for a hospital item or service.
  3. The payer-specific negotiated charge is the charge that a hospital has negotiated with a third-party payer for an item or service.
  4. The de-identified minimum negotiated charge is the lowest charge that a hospital has negotiated with all third-party payers for an item or service.
  5. The de-identified maximum negotiated charge is the highest charge that a hospital has negotiated with all third-party payers for an item or service.

NMRMC is required to update this information at least annually. For this reason, it is possible that the information contained in the file may not reflect NMRMC’s current prices, currently negotiated rates, or current services.

  • While this document outlines standard base charges, and certain other information, these are not necessarily charges a patient will have to pay.
  • Every patient visit is unique and actual payment is highly dependent upon a combination of factors.
  • Even for similar procedures at the same facility, what a patient pays may differ based on their insurance plan and other factors.
  • The prices in this machine-readable format may not reflect any quality incentives or accountable care organization arrangements that NMRMC may have with the individual payers.
  • The prices will not reflect any coinsurance, copays, deductibles, or out-of-pocket maximums affecting the patient’s final bill.
  • The prices included do not include those costs associated with other providers, which are often billed separately. These charges may include services performed by pathologists, radiologists, or anesthesiologists.
  • These prices are not intended for media use.

We have provided an accurate, machine-readable file considering the limitations of these complexities. The following links provide Price Transparency information for services performed at Neosho Memorial Regional Medical Center.

Click on the links below for pricing transparency details :

  1. Shoppable Services
  2. Standard Charges

Files will continue to be updated

Comprehensive Health Plans

The Transparency in Coverage final rule (CMS-9915F) requires group health plans and health insurance issuers, including self-funded plans are required to make available to the public, including stakeholders such as consumers, researchers, employers, and third-party developers, three separate machine-readable files that include detailed pricing information was published in the Federal Register on October 29, 2020. In accordance with this rule, as of July 1, 2022, these files must be posted on the group health plan or health insurance issuer’s public website. The first file will show negotiated rates for all covered items and services between the plan or issuer and in-network providers. The second file will show both the historical payments to, and billed charges from, out-of-network providers. Historical payments must have a minimum of twenty entries in order to protect consumer privacy. UnitedHealthcare, UMR, and HealthSCOPE Benefits creates and publishes the required machine-readable files on behalf of NMRMC.

We want to help our patients understand.
For assistance in estimating out-of-pocket expenses, please contact:

Financial Counselor
Email: scheduling@nmrmc.com
Phone: 620-432-5386
 
For questions regarding charges, please contact:
Patient Financial Services
Phone: 620-432-5444

Notes
  1. Please note that this list of charges is not a contractual offer and does not constitute an agreement to provide services. The list is merely an invitation to treat or seek services, subject to change at any time.
  2. The CY 2020 Outpatient Prospective Payment System (OPPS) Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates: Price Transparency Requirements for Hospitals to Make Standard Charges Public (CMS-1717-F2) final rule (Hospital Price Transparency final rule) was published in the Federal Register on November 27, 2019 and hospitals were required to comply as of January 1, 2021.

The Centers for Medicare and Medicaid Services (CMS) recognizes the ability to price shop across settings, and calculate and compare out-of-pocket costs, requiring data from both providers and payers.

 

Page updated 04/23