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Pricing Background and Disclaimers

IMPORTANT INFORMATION ON HEALTH INSURANCE PRICING

Straight dollar comparisons do not tell the whole story. We encourage patients to speak to their health insurance company or call us at 215-728-2678 or 215-728-3162 to get the most accurate cost information. Comparison of standard charges across plans is not suitable to draw conclusions about whether one payer pays a provider more than another. Each contract between a payer and a provider is structured differently. Some payers may choose to pay more in the form of value-based lump sum payments—e.g., financial incentive bonuses for meeting quality benchmarks, rather than in fee-for-service prices. The amounts in the Machine Readable File do not include these value-based payments. The amounts posted may represent a per diem amount (i.e. amount paid per day), case rate (the amount of reimbursement for a package of services), an amount derived as a percent of charges, or some other reimbursement method, which will vary by payer. Put into plain language, it means that such apple-to-orange comparisons of simple dollar amounts can be highly misleading. These amounts should not be used by consumers as the expected price they would pay out of pocket for care. The hospital standard charges included in this file are subject to change during the course of the year. Fox Chase will aim to update this file annually, consistent with Federal regulations.

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