Patient Price Information List

In an effort to assist our patients in making informed decisions regarding the quality and charges of the care they receive, Hocking Valley Community Hospital is providing this price list containing our charges for Room and Board, Emergency Department, Operating Room, Delivery, Physical Therapy and other procedures.  Our hospital’s charges are the same for all of our patients, but a patient’s responsibility may vary, depending on the payment plans negotiated with the individual’s health insurance provider.  Uninsured and underinsured patients should consult with our Patient Accounts staff to determine whether they qualify for discounts.  These prices are correct as of July 24, 2007.

 

Room & Board – Per Day Charges

Special Care Unit	$800.00
Obstetrics	$497.30
Nursery	$414.50
Medical Surgical Unit Private	$500.00
Semi-Private	$465.00
Skilled Nursing Facility	$172.60
Behavioral Health Unit	$850.00

 

Labor & Delivery Charges
The following is a list of estimated charges for a normal delivery.  These are not actual charges, but an average of labor and delivery costs.  Fees for physician services or anesthesia administration are not reflected, and will be billed separately by your physician.

Normal Delivery	$5,450.00
Cesarean Section	$8,500.00
Normal Newborn	$2,100.00

 

Emergency Department  & Urgent Care Charges
Emergency Department and Urgent Care charges are based on the level of emergency care provided to our patients. Patients are assessed by a nurse upon arrival to determine which department of care, either emergent or urgent is most appropriate.  The levels, with level 1 representing basic emergency or urgent care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment.  The following charges do not include fees for drugs, supplies, or additional ancillary procedures that may be required for a particular emergency treatment.  They also do not include fees for Emergency Department physicians, who will bill separately for their services.

Emergency Department 

Level 1	$110.00
Level 2	$150.00
Level 3	$225.00
Level 4	$295.00
Level 5	$463.50
Level 6 (Critical Care)	$825.00

 
Urgent Care

Level 1	$80.70
Level 2	$97.20
Level 3	$144.55

 

Operating Room Charges
Operating Room charges are based on the length of time involved in the procedure, as well as the time spent while the patient is in recovery.  These charges do not include charges for anesthesia, drugs, or supplies required for a particular surgery.  Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

Operating Room per minute	$35.00
Recovery Room per minute	$16.65

 

Physical Therapy Charges
The following charges represent the most common services offered by our Physical Therapy department.  Patients may have additional charges, depending on the services performed.

PT Evaluation	$194.10
Therapeutic Exercise (ea 15 minutes)	$87.75
Gait Training (ea 15 minutes)	$53.45
Manual Therapy (ea 15 minutes)	$66.05
Therapeutic Activities (ea 15 minutes)	$90.45

 

Occupational Therapy Charges
The following charges represent the most common services offered by our Occupational Therapy department.  Patients may have additional charges, depending on the services performed.

OT Evaluation	$194.10
Therapeutic Exercise (ea 15 minutes)	$90.40
Therapeutic Activities (ea 15 minutes)	$90.45
Self Care / Home Mgmt Training (ea 15 minutes)	$75.70
Neuromuscular Education (ea 15 minutes)	$61.15

 

Respiratory Therapy Charges
The following charges represent the most common services offered by our Respiratory Therapy department.  Patients may have additional charges, depending on the services performed.

Aero Mobil / Broncho / Sput	$38.25
ECG 12 Lead Tracing Only	$149.00
Pulm Rehab Exer Group Session	$67.90
Incentive Spirometry (ea 15 minutes)	$35.00
Oxygen per Hour – 1st Hour	$25.75
Oxygen per Hour – Ea. Additional Hour	$7.20

 

Radiology Procedure Charges
The following charges represent the 30 most common procedures offered by our Radiology department.  Patients may have additional charges, depending on the services performed.  Fees for Radiology interpretation are also not reflected, and will be billed separately by your physician.

Abdomen Exam Series	$209.15
Abdomen Flat	$133.50
Ankle	$160.00
Cervical Spine Min 4 View	$250.00
Chest w/ Lateral	$183.20
CT Abdomen w/ Contrast	$1,355.60
CT Abdomen w/o Contrast	$1,105.60
CT Chest w/ Contrast	$1,355.60
CT Chest w/o Contrast	$1,105.60
CT Head w/o Contrast	$800.00
CT Pelvis w/ Contrast	$1416.60
CT Pelvis w/o Contrast	$1,166.60
Dexa Scan	$250.00
Foot	$160.00
Hand	$160.00
Hip Minimum 2 Views	$160.00
Knee 3 Views	$160.00
Lumbar Spine w/ Obliques	$268.00
Mammography Bilateral Diagnostic	$169.75
Mammography Screening	$116.30
Myocardial Perfusion/Stress/Rest	$1,427.20
Myocardial Perfusion Wall Motion	$333.05
Myocardial Perfusion w/ Ejection Fraction	$425.00
Shoulder Minimum 2 view	$160.00
Thoracic Spine w/ Swimmers View	$241.45
Ultrasound / Echo Gall Bladder	$526.85
Ultrasound / Echo Kidney	$526.85
Ultrasound / Echo Pelvis	$526.85
Ultrasound Vaginal	$526.85
Wrist	$160.00

 

Laboratory Charges
The following charges represent the 30 most common procedures offered by our Laboratory department.  Patients may have additional charges, depending on the services performed.  Fees for Pathology interpretation are also not reflected, and will be billed separately by your physician.

ABO Blood Type	$32.85
Alanine Amino (ALT SGPT)	$46.10
Basic Metabolic Panel	$85.00
CBC / Platelet & Auto Differential	$41.15
CK Total	$38.00
CKMB Profile	$71.00
Comprehensive Metabolic Panel	$116.35
Creatinine, Serum	$32.80
Culture – Blood	$79.10
Culture – Urine	$71.30
Definitive ID Micro	$38.30
Glucose – Fasting	$30.45
HCG Urine	$41.95
Hematocrit / Hemoglobin	$23.00
Hemoglobin A1C	$61.05
Hepatic Function Panel	$69.20
Lipid Panel Profile	$80.00
Magnesium	$50.40
MI Panel	$222.45
Protime	$32.95
PSA, Total	$100.00
RH Blood Type	$32.85
SED Rate (ESR)	$25.80
Sensitivity	$56.50
Strep A Screen	$75.00
Thromboplastin Time, Partial	$41.40
Thyroid Stimulating Hormone	$88.00
Transferase (AST SGOT)	$40.65
Troponin	$80.00
Urinalysis w/ Microscopic	$38.30

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Hospital Billing Policies

Prompt Pay Discount
A discount of 15% will be provided for patient responsibility amounts (copay, deductible, self-pay amounts) paid at the time of service.  A discount of 10% will be provided to account balances paid in full within 30 days of insurance payment. 

Availability of Uncompensated Services
Hocking Valley Community Hospital is required by federal law to provide a reasonable amount of care without charge to persons who are unable to pay.  This obligation is known as the Hospital Care Assurance Program (HCAP). Uncompensated services are available to patients whose family income does not exceed the limits designated by the Department of Health and Human Services which are set forth below.  Please review the income limits.  If you believe that you may be eligible for uncompensated services and wish to request them, please contact the Patient Accounts department, or you may obtain an application by mail.  A written determination of your eligibility will be made within two working days of your request.

POVERTY INCOME GUIDELINES FOR ALL STATES
(Except Alaska and Hawaii)

Effective 1/24/07
The 2007 Poverty Income Guidelines are: 

FAMILY SIZE	INCOME GUIDELINE
1	$10,210
2	$13,690
3	$17,170
4	$20,650
5	$24,130
6	$27,610
7	$31,090
8	$34,570
Add $3,480 for each additional person if the family unit has more than eight members.

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Interest Charges
Hocking Valley Community Hospital currently does not charge interest on unpaid accounts.

Questions Concerning Bill
If patients have questions concerning their bill, or would like to see if they qualify for discounts or uncompensated services, they may do so by contacting the appropriate account representative below.

BWC / MMO / Blue Cross	(740) 380-8129
Commercial Insurance Accounts	(740) 380-8132
Emergency Medical Services Accounts	(740) 380-8130
HCAP/Collections	(740) 380-8127
Medicaid Accounts	(740) 380-8132
Medicare Accounts	(740) 380-8128
Medicare Accounts	(740) 380-8124
Skilled Nursing Facility Accounts	(740) 380-8133
Customer Service Representative	(740) 380-8270

Consumers can access a number of government and private Websites, which provide additional information on hospitals’ charges and quality.  For a complete listing of available online resources, please visit The Consumer’s Guide To Quality Health Care In Ohio at the following address:

www.ohanet.org/portal

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