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Billing and Pricing
For billing questions, please call 312.996.1000 or visit the account representatives available in the lobby of the Outpatient Care Center (OCC), 1801 W. Taylor, Chicago. Stop by Monday-Friday from 8:30AM-4:30PM and speak with a representative ready to answer your billing questions or to help you make a payment.
The hospital will provide pricing information to patients upon request. If you would like to request pricing for hospital services, please contact 312.996.1000 or email firstname.lastname@example.org. If you need financial assistance, please refer to the Financial Assistance section of our website or call 866-600-CARE for more information.
Frequently Asked Questions
1. How much will I have to pay out of my pocket?
- If you have health insurance, you will need to pay the deductible, copay and/or coinsurance set by your health plan. If you have reached your maximum out of pocket or met your deductible for the year or if you have secondary insurance coverage that provides additional coverage, you may not owe anything. Your financial obligations could differ depending on whether the hospital or physicians are "out-of-network," meaning the health plan does not have a contract with them. Please contact your insurance company to understand what your financial obligations will be.
- If you do not have health insurance, we will discuss financial assistance options available that could include either a complete write-off or a substantial reduction of the charges in accordance with UI Health's financial assistance programs.
2. What does my health insurance pay?
Health plans such as Medicare, Medicaid, workers' compensation, commercial health insurance, etc., do not pay charges. Instead, they pay a set price that has been predetermined or negotiated in advance. You only pay the out-of-pocket amounts set by your health plan.
3. What do the following health insurance terms mean?
Deductible means the amount you need to pay for health care services before the health plan begins to pay. The deductible may not apply to all services.
Copay means a fixed amount (for example, $20) you will have to pay for a covered health care service, such as a physician office visit or prescription.
Coinsurance means the percentage you pay for a covered health service (for example, 20% of the bill). This is based on the amount your health plan determines is the allowed amount for the service. You pay coinsurance plus any deductibles you may owe.
Your specific health care plan coverage, including the deductible, copay and coinsurance, varies depending on what plan you have selected. Health plans also have differing networks of hospitals, physicians and other providers that the plan has contracted with. It is important that you contact your health plan to discuss this specific information.
4. What is the difference between charges, cost and price?
Total Charge is the amount set before any discounts. Hospitals are required by the federal government to utilize uniform charges as the starting point for all bills.
The charges are based on what type of care was provided and can differ from patient to patient for similar services, depending on any complications or different treatment provided due to the patient's health.
Cost for a hospital is the total expense incurred to provide health care. Hospitals have higher costs to provide care than freestanding or retail providers, even for the same type of service. This is because a hospital is open 24 hours a day, 7 days a week and needs to have everything necessary available to cover any and all emergencies. Non-hospital health care providers can choose when to be available and typically would not provide services that would result in losses.
Total Price is the amount actually paid to a hospital. Hospitals are paid by health plans and/or patients, but the total amount paid is significantly less than the total charge.
- Medicare, Medicaid and most private insurers pay hospitals according to a set fee schedules or discounts depending on the service provided, much less than the hospital charge.
- Under the Illinois Hospital Uninsured Patient Discount Act, Illinois hospitals provide free care to uninsured patients with incomes up to 200% of the federal poverty level (FPL) in urban areas ($47,700 for family of 4 in 2014).
- Illinois hospitals provide discounts to 135% of the hospital's costs to patients with incomes up to 600% FPL in urban areas ($143,100 family of 4 in 2014). For the University of Illinois Hospital (applicable to 2014) this cost based discount is a 55% discount from our standard charge.
5. How can I use this hospital charge information for comparing prices?
Charge information by itself is not necessarily useful in order to determine how much you ultimately may need to pay or to compare the amount you may owe across hospitals. Discounts and fee schedules are used to determine how much private insurers pay and may vary from hospital to hospital. These amounts create what is referred to as an allowed amount which is then used by your insurer to determine how much you may owe.
6. How can I get an estimate for a specific procedure?
If you need an estimate for a specific procedure, please contact Hospital Patient Accounts at 312-996-1000 or email@example.com.
Estimates will be an average charge for the procedure without complications. A physician must determine specific care you may require based on considerations including your specific diagnosis, general health condition and many other factors. For example, one individual may require only a one-day hospital stay for a particular procedure, while another may require a two-day stay for the exact same procedure.
Remember that you will not pay charges. Rather, if you have health insurance, you will only pay the specified deductible, copay and coinsurance amounts established by your health plan. If you do not have health insurance, you may be eligible for significant discounts from charges.
Please contact Hospital Patient Accounts at 312-996-1000 or firstname.lastname@example.org to obtain further information about pricing at UI Health and discounts that are available to you. If you are interested in enrolling in coverage programs available under the Affordable Care Act or applying for financial assistance, please contact 866-600-CARE.