How much could my services cost?
Estes Park Health (EPH) can provide estimates for medical care as a part of our shoppable services and all services price list which together is the “Federally Required Transparency Data” published pursuant to federal law and regulation. You may use this tool or contact our EPH Team at (970) 577-4525 for an estimate of your costs and out-of-pocket responsibility. Estimates provided by the tool may vary from actual costs and out-of-pocket responsibility based on individual circumstances. EPH strongly encourages you to contact your health insurance to understand your benefits, the amount you may owe and ensure EPH is in-network with your insurance plan. Ultimately, your insurance is an agreement between you and the insurance company. Your insurance benefits will determine the amount you owe to the facility (including deductibles, co-pay, co-insurance, and out-of-pocket maximums).
The Federally Required Transparency Data is based on information we have gathered from our claims and insurance payment files. It is not a guarantee of what you will be charged or what you will owe. The actual charges may differ from the information in the Federally Required Transparency Data for many reasons, including but not limited to: the seriousness of your medical condition, the duration of your care, the services and supplies you receive, any complications you may have, and additional tests/procedures your provider orders.
The Federal Price Transparency Data only includes the fees charged by providers who are employed by our facility. The Federal Price Transparency Data specifically identifies when employed physician charges are included. There may be other non-employed providers involved in your care whose charges are not included. That may include, but is not limited to providers such as radiologists, hospitalists and outsourced lab billing companies.
If I call for pricing, what information do I need to have ready?
When you call us, please try to have the following information at hand so that we can provide you with our best estimate of pricing:
· Description of services needed—as much information as possible about the specific services needed as described by your physician
· Type of services needed—if you will be admitted to the hospital as an inpatient overnight, or if you are expected to be treated on an outpatient basis
· Physician/specialist name—i.e., if you are having surgery, provide surgeon's name
Can I get an exact pricing quote?
We do our best to provide you with a price or pricing range based on our hospital's historical pricing for comparable services. However, your actual bill might vary, and our pricing estimates are not guaranteed because the services each patient requires can vary, and your bill reflects your individual circumstances at the time your services are rendered.
Our Pre-Access Services Specialist (970-577-4525) will contact you prior to services or meet with you at a pre-op appointment to help you understand your financial responsibility to the hospital and/or your health care provider based on your insurance benefits. They will assist you in understanding terms like:
· Co-payments – The portion of your bill you are required to pay at the time of registration. Co-payment amounts vary depending on your insurance policy.
· Deductibles – The amount your insurance company determines you must pay before they begin dispensing benefits on services rendered.
· Co-Insurance - Coverage in an insurance plan where the insured pays a share of the payment made on an account. For example, a patient with 70% co-insurance would mean their insurance plan pays 70% and the patient is responsible for 30%
· Insurance Claims – The bill for services the hospital submits to your insurance company or companies.
· Itemized bills – A list of individual charges for services and procedures you received during your hospital stay. Also lists your account number.
· Patient Balance – The amount on your bill that you need to pay.
· Statement of Account – Shows any activity (for example, insurance payments or denials) that has occurred since the itemized bill was sent.
Since every insurance plan is different, please be sure to check your coverage and ask questions prior to receiving treatment. Not following your insurance company's rules could result in a larger financial responsibility for you. Estes Park Health Financial Counselors can help you understand your financial rights and responsibilities associated with your services and procedures.
What is expected of patients in terms of payment?
Similar to visits to your physician's office, we expect payment at time of service. If you have insurance or other coverage, we expect you to pay your co-payment,
coinsurance and/or deductible upon arrival at the hospital based on the estimate for services. After your insurance company pays us, we will send you a statement for any amount you may still owe.
To help you navigate on-going changes, Estes Park Health now provides you with access to a Patient Financial Customer Service Representative (970-577-4530, 970-577-4528) and a Financial Counselor (970-577-4327) dedicated to resolving patient balances.
If you are uninsured, we expect payment at time of service (or will work with you to arrange monthly payments) for the estimated price of your services. If, after your services are received, any additional payment is due, we send you information about any amount you may still owe. If you receive emergency care and cannot pay for your services, with your cooperation, our financial counselors evaluate whether you qualify for local and state programs, including Medicaid.
We accept major credit cards, checks, money orders and cash.
What does "uninsured" mean?
An uninsured person is someone who does not have insurance or coverage for hospital services by a third party like Medicare, Medicaid, workers compensation or an insurance company. Other common terms used when referring to uninsured patients are "self pay" and "private pay."
Estes Park Health participates in the Colorado Indigent Care Program. CICP provides discounted health care services to low income people and families. CICP is not a health insurance program. Discounted health care services are provided throughout Colorado by hospitals and clinics that
To be considered for CICP:
· The date of service and/or the last insurance payment date must be within 90 days from the application date.
· The patient must have already applied for and been denied by Medicaid. You can visit Colorado.gov and learn more about this program as well as identify if you may be eligible. Income guidelines and the application process are available on the website.
Estes Park Health is committed to caring for our patients, regardless of their financial circumstances. We strive to help address patients’ financial responsibilities in a way that is sensitive and fair to their circumstances.
Uninsured patients who meet eligibility requirements are qualified to be screened for Financial Assistance. If you are an uninsured patient and need assistance with your medical bill, please call our Customer Service Department at (970) 577-4530.
To be considered for Financial Assistance:
· The date of service and/or the last insurance payment date must be within 240 days from the application date.
· The patient must have already applied for and been denied by Medicaid and CICP.