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Healthcare Pricing Transparency
As part of the 2019 IPPS Final Rule, the Centers for Medicare and Medicaid Services (CMS) requires hospitals to provide patients a listing of standard hospital charges.
As a result, to remain in compliance with federal law, Everest Rehabilitation provides price transparency and patient billing information to all patients. With that, we have listed our standard procedures and charges directly on our website. Please note, actual charges will vary based on medical need at the time services are rendered. Please contact the Hospital Business Office if you have any questions about our standard charges or to obtain a prospective service quote. Fees for physician services are not reflected in our standard charge list and will be billed separately by your physician.
Please note the following:
Actual costs may exceed the estimate.
Physician services may be billed separately. Physicians may or may not participate with the same health insurers or health maintenance organizations (HMOs) as Everest Rehabilitation Hospital. You should contact the health care practitioner who will provide services to you to determine which health insurers and HMOs they participate in as a network provider or preferred provider, as well as request a personalized estimate of reasonably anticipated charges for the treatment of your specific condition.
You may pay less for services at another facility or in another health care setting.
Health plans can be very different, and we encourage you to contact your health insurance provider directly if you have questions about your deductible, copayment, coinsurance and benefit limits. If you are not covered by health insurance, we encourage you to contact the hospital at the hospital number listed to determine if you qualify for discounts and discuss payment options prior to receiving health care services from our inpatient rehabilitation facility.
Before we bill you, we will bill your insurance provider, including Medicare and Medicaid if applicable, and any additional insurance providers. We do not charge interest on any balance due after insurance payments are received.
Note: Section 2718(e) of the Public Health Service Act, as enacted by the Affordable Care Act, requires “each hospital operating within the United States” to “make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups (DRGs) established under section 1886(d)(4) of the Social Security Act.”
Section 4421 of the Balanced Budget Act (BBA) of 1997 (Public Law 105-33), as amended by section 125 of the Balanced Budget Refinement Act (BBRA) of 1999, authorized the implementation of a per discharge prospective payment system (PPS), through section 1886(j) of the Social Security Act, for inpatient rehabilitation hospitals (IRFs). Section 1886(j)(2)(A) provides that Medicare will pay for treatment in an IRF by dividing patients into case-mix groups, CMGs, that are predictive of the resources needed to furnish patient care to various types of patients.
Reporting of a quality or safety concern to CIHQ can be accomplished by any of the following:
Center for Improvement in Healthcare Quality
P.O. Box 3620
McKinney, TX 75070
In-Person by Appointment:
Contact CIHQ at (866) 324-5080 for instructions.
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