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Understanding costs

University Health is interested in helping you understand the costs associated with your healthcare. University Health lists the charge price (CDM) for the procedures and services we perform. The charges contained in University Health's CDM are the same for all patients. However, the charges in the CDM do not reflect University Health's actual reimbursement from patients or insurance companies. University Health's actual reimbursement is influenced by a variety of internal and external factors, including negotiated health plan rates, fixed government rates, individually negotiated package pricing, fixed fund distributions for indigent care populations, prompt payment discounts and self-pay patients. Other factors affecting reimbursement could include whether a procedure was performed on an inpatient or outpatient basis, physician orders, comorbidities and complications, medical necessity, and specialty services and procedures.

If you are comparing University Health's CDM to the CDMs of other hospitals, it is important to note that descriptions and charges contained in the CDMs may vary from hospital to hospital. Among the reasons for this variance are that different hospitals may include different goods, supplies or procedures under a similarly named description. Items or services that are special ordered by a physician are typically not included in room or procedure charges. Most treatments or services provided by ancillary department staff, such as respiratory therapy, laboratory, rehabilitation and pharmacy, are separate distinct services that we are required to bill separately. University Health does not employ many of the physicians who may provide services within the healthcare system. Charges for most physician services are not included in the CDM.

Provider-based billing rules FAQs (PDF)

Price transparency

University Health is interested in helping you understand the costs associated with your healthcare. University Health lists the charge price (CDM) for the procedures and services we perform. The gross charges contained in University Health's CDM are the same for all patients.

University Health's actual reimbursement, though, is influenced by a variety of internal and external factors, including negotiated health plan rates, fixed government rates, individually negotiated package pricing, fixed fund distributions for indigent care populations, prompt payment discounts and self-pay patients.

As of January 1, 2021, the Centers for Medicare and Medicaid Services (CMS), requires all hospitals to provide their payer-specific negotiated charges (rates) for each service. More information about this large initiative can be found at https://www.cms.gov/hospital-price-transparency.

You will find two files on University Health's website that detail the following:

  1. A comprehensive machine-readable file with all items and services
  2. A display of at least 300 shoppable services in a consumer-friendly format.

Both files must include the following:

  1. Gross Charges
  2. Payer-specific Negotiated Charges (rates)
  3. De-Identified Minimum Payer-specific Negotiated Charges (rates)
  4. De-Identified Maximum Payer-specific Negotiated Charges (rates)
  5. Discount Cash Price

Shoppable services are services that can be scheduled in advance such as imaging, labs and other diagnostic procedures. University Health has shared a list of shoppable services as they are generally billed. The expected payer-specific negotiated charges are an estimate only. There may be adjustments to the expected due to final diagnosis changes, any unknown circumstances or complications as well as if further treatment was recommended.

Also, please note most services will still require a physician order. The payer-specific charge is assuming coverage by your payer. Payer-specific negotiated charges are subject to change based on the payer updating their rate and fee schedules throughout the year. If you are covered by a payer's health insurance, we encourage you to contact your health insurance company to determine accurate information about your financial responsibility portion of the payer-specific negotiated charge. Your out of pocket costs are based on several factors such as insurance plan deductible, copayment and coinsurance amounts as well as how much you have met on each of those factors year to date.

If you are comparing University Health's files to other hospitals, it is important to note that descriptions and charges contained in the may vary from hospital to hospital. Among the reasons for this variance are that different hospitals may include different goods, supplies or procedures under a similarly named service or description.

At University Health, we are committed to price transparency and helping you navigate through your entire healthcare journey. We understand part of the journey involves the cost of care. We will continue to update this site with further information to assist.

Download File Here:

University Health Truman Medical Center Standard Charges
University Health Truman Medical Center Shoppable Services
University Health Lakewood Medical Center Standard Charges
University Health Lakewood Medical Center Shoppable Services