|
Welcome to Texas PricePoint
Welcome to Texas PricePoint, a user-friendly resource for information on
Texas hospitals. Texas PricePoint is sponsored by the
Texas Hospital Association, an Austin-based nonprofit statewide trade
association representing hospitals and health systems. This site was created to
provide basic demographic, quality and charge information on Texas hospitals
and to promote consumer/hospital interaction.
Because the consumer's role in managing his/her own health care is changing,
Texas hospitals made a commitment to provide information regarding hospital
charges and quality.
Texas PricePoint provides:
-
Charge data on the most common inpatient services;
-
Links to quality data; and
-
General and contact information for Texas hospitals.
The content on this Web site is intended for informational purposes only and
should not be used solely when making health care decisions. All the data on
this Web site were collected by the Texas Department of State Health Services,
a state agency and independent source, and was not modified in any way by the
Texas Hospital Association or its contractor.
This information can be used as a factual starting point for a more informed
discussion among consumers, insurers and providers of care. This Web site
contains information on the most common services and quality measures only;
specific questions you may have might not be addressed here. To receive more
specific information on services for yourself or a family member, please
contact your hospital and/or health insurance provider directly. Also, please
talk to your doctor or other qualified health provider about this information
to help you, your family and your friends make the best health care decisions
for your specific circumstances.
Things to Know When You Look at Texas PricePoint Reports
IF YOU HAVE COMMERCIAL INSURANCE
...
-
Commercial insurers negotiate discounts with hospitals on behalf of the
patients they represent. The discounts vary among insurers.
-
Numerous factors, such as type of plan, co-pay, co-insurance, deductible,
out-of-pocket maximums and any limitations on coverage – such as whether or not
the hospital is a participating provider in the insurance plan’s network – also
will affect your financial responsibility to a hospital.
-
Begin by contacting your insurance company to understand all of the factors
affecting your financial responsibility.
IF YOU HAVE MEDICARE ...
-
Medicare pays hospitals according to a set fee schedule that represents a
discount from a hospital’s billed charges.
-
Medicare will pay for many of your health care expenses but not all of them.
-
Special rules apply if you have employer group health insurance coverage
through your own job, a spouse's job or coverage thru a Medicare HMO/PPO.
-
If you have a supplemental insurance policy, it may cover some costs Medicare
does not cover.
-
Contact Medicare at http://www.medicare.gov/
IF YOU HAVE MEDICARE MANAGED CARE (PPO or HMO)
-
Medicare Choice plans and PPOs negotiate discounts with hospitals on behalf of
the patients they represent. The discounts vary among the plans or PPOs.
-
Numerous factors, such as type of plan, co-pay, co-insurance, deductible,
out-of-pocket maximums and any limitations on coverage – such as whether or not
the hospital is a participating provider in the Medicare Choice plan’s network
– also will affect your financial responsibility to a hospital.
-
Begin by contacting your Medicare Choice plan or PPO to understand all of the
factors affecting your financial responsibility.
IF YOU HAVE MEDICAID ...
-
Medicaid pays hospitals in accordance with a set fee schedule that represents a
discount from a hospital’s billed charges.
-
Generally, Medicaid recipients are not responsible for any portion of the bill.
-
Contact your local Medicaid office or visit the Texas Health and Human Services
Commission at http://www.hhsc.state.tx.us/medicaid/index.html
IF YOU HAVE MEDICAID MANAGED CARE (STAR, STAR+PLUS) OR CHIP
-
Medicaid managed care plans and Children’s Health Insurance Program (CHIP)
plans negotiate discounts with hospitals on behalf of the patients they
represent. The discounts vary among the plans.
-
Numerous factors, such as type of plan, co-pays if applicable, out-of-pocket
maximums and any limitations on coverage under your Medicaid managed care plan
or CHIP also will affect your financial responsibility to a hospital.
-
Begin by contacting your Medicaid managed care plan or CHIP plan to understand
all of the factors affecting your financial responsibility.
IF YOU ARE UNINSURED ...
-
For patients who do not have insurance, hospitals typically offer
discounts. Some discounts may be based on the patient’s income level and family size.
-
You should contact the hospital’s business office for information on the
hospital’s policies and how to request a discount. In some cases, you may be asked to verify income or other assests to determine whether or not you qualify for full or partial financial assistance.
-
Access on-line information provided by the
Texas Department of Insurance to help you shop for health care coverage at
www.texashealthoptions.com.
|