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.
Pay a Bill
First: identify which type of bill you need to pay (please click on the image that looks the most like the bill you received).
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. You can also refer to additional information found at the links below which includes the current hospital charge master and the average charge by diagnosis related grouper (DRG). If you need financial assistance, please refer to the Financial Assistance section of our website or call 312.413.7621 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 list of charges is the same for all patients. However, the total charges for an individual patient often vary from one patient to another for several reasons, , including but not limited to:
- How long it takes to perform the service
- How long it takes you to recover in the hospital
- Whether the service or procedure you receive is more difficult than expected
- What kinds and dosage of medication you require
- If you experience complications and need additional treatment
- Other health conditions you may have that may affect your care
Hospital charges are listed in the charge master. A charge master is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital- each test, exam, surgical procedure, room charge, etc. Given the many services provided by hospitals 24 hours a day, 7 days a week, a charge master contains thousands of services and related charges.
Patients can find a list of services and their charges by clicking here.
It is very important for patients to understand that charge master amounts are almost never billed to a patient or received as a payment by a hospital. The charge master amounts are billed to a health insurance company (commercial or government) and those insurers then apply their contracted rates to the services that are billed. In situations where a patient does not have insurance, UI Health has financial assistance policies that apply discounts to the amounts charged. Click here for more information on our financial assistance policies.
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 ($50,200 for family of 4 in 2018). In addition, Illinois hospitals provide discounts to the hospital's costs to uninsured patients with incomes up to 600% FPL in urban areas ($150,600 family of 4 in 2018). For the University of Illinois Hospital (applicable to 2018) this cost based uninsured discount is a 70% discount from our standard charge.
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. Health insurance companies contract with hospitals to care for their customers. Hospitals are paid the insurance company’s contract rate, which generally, is significantly less than the amount listed on the charge master. The insurance company’s contract rate, not the charge master, is the basis for determining the patient’s actual out of pocket costs. For example, a hospital may charge $1,000 for a service, which the insurer’s contact rate may be $700. If the patient’s insurance plan indicates the patient is responsible for 20 percent of the contract rate, the patient would owe $140 ($700 x 20%).
5. Are pharmaceuticals and supplies included in the charges?
Pharmaceutical and supply items will be listed in the charge master, however, unlike other services, these items are variably priced based on a number of criteria, which are listed below. For the purpose of displaying the price in the posted charge master file, we have used a fixed price or, when indicated, an average price based on historical utilization.
Total charges for pharmaceuticals and supplies often vary from one patient to another for several reasons, including but not limited to:
- What medication is dispensed and administered, and what is the dosage and/or route of administration (i.e. oral tablet, topical patch, intravenous infusion, etc)
- What manufacturer product(s) is associated to each pharmaceutical or supply charge code
- What cost is being used to calculate pharmacy or supply charges (i.e. acquisition cost, average wholesale price, average sales price)
- What location uses the product
- How pharmaceuticals are categorized by product (i.e. chemotherapy, injectable, unit dose, etc.)
Please note, like other services, the amount listed is used to calculate a billed amount and not representative of the expected patient responsibility. Additionally, it is important to understand that these pharmaceutical items listed in the charge master are for products billed within the hospital setting and differ from the retail pharmacy setting.
6. 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.
7. How can I get an estimate for a specific procedure or service?
If you need an estimate for a specific procedure or service, 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 in accordance with the hospital financial assistance policy.
8. Are there services not included in the charge master?
UI Health’s charge master does not include charges for services provided by the doctor (or doctors) who treat a patient while he/she is at the hospital. The charge master only includes hospital billed services. The patient may receive separate bills from the hospital and the doctors involved in your care.
Here is partial list of health care providers who may bill you separately:
- Your personal doctor, if he/she sees you in the hospital
- The surgeon who performs your procedure
- The anesthesiologist who works with the surgeon
- The radiologist who reads your x-rays or other imaging
- Other doctors who may be consulted by your doctor during your time in the hospital
- Pathologist who reads the pathology report
We are here to help you navigate the process of healthcare costs and billing. If you have questions or need our help, do not hesitate to 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 may be 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 312.413.7621.