Standard Hospital Bills

What is a standard hospital bill?

A standard hospital bill is the bill you will receive after you’ve been to the hospital. The standard hospital bill lists total charges along with any discounts offered, insurance company coverage, and what you as the patient owe.

How do I get a standard hospital bill?

Your hospital should send you a standard bill after medical services are rendered. Hospital bills can be overwhelming, but understanding how to read your hospital bill is important. Let’s break down your hospital bills piece by piece below.

Amount You Owe (“Balance”)

The amount you owe (“balance”) is the result of subtracting insurance adjustments and the insurance payment from billed charges.

  • Billed Charges: These are the “full-rack” rates that the hospital charges only to uninsured patients. Insurance companies never pay this rate and neither should you. 
  • Insurance Adjustments: The discount that the insurance company has pre-negotiated with the hospital.
  • Insurance Payment: The amount that the insurance company actually pays the hospital.
  • Balance: The balance is the amount the hospital says you owe, or the billed charges remaining after the insurance adjustment and the insurance payment are subtracted. If you have insurance, this may be a copay or deductible.

Other itemized hospital bill terminology to know:

  • Gross Charges: Billed charges are sometimes listed as “gross charges”
  • Chargemaster Rate: Billed charges are sometimes listed as the “Chargemaster Rate”
  • Contractual Amount: The insurance adjustment is sometimes referred to as the “Contractual Amount”
  • Contractual Discount: The insurance adjustment is sometimes referred to as the “Contractual Discount”
  • Allowed Amount: The insurance payment is also known as the “Allowed Amount”
  • Patient Portion: The patient portion is the balance after insurance adjustments and payments.

Beyond hospital bill charges, you may also find it helpful to understand key health insurance terms so you can be as prepared as possible when discussing your medical bill with your insurance company or hospital.

Tips for reviewing your hospital bill

When reviewing your hospital bill, keep these tips below in mind in order to best discuss or negotiate your hospital bill when needed. 

  • Check the math on your hospital bill: Make sure the balance is equal to the billed charges minus the insurance adjustment and the insurance payment.
  • Confirm the plan discount: iIf you are insured, make sure a Plan Discount is itemized on the bill. If not, call your insurance company.
  • Request more detail: iIf you believe your balance owed is unreasonable, request an itemized hospital bill.

If your hospital bill is overwhelming or you’re dealing with an outrageous medical bill and need help negotiating your bill, get in touch with our expert medical bill advocates at Resolve today. We’re here to help.

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