Pricing Transparency
Our Commitment to Pricing Transparency
Spencer Hospital makes patient satisfaction a priority, which includes pricing transparency related to the services it offers.
We invite you to use our online price estimator tool. The estimate is only for out-of-pocket costs for services at Spencer Hospital. Additional services that may not be part of the estimate include, but are not limited to, professional fees, anesthesia services, and radiology professional services.
Estimates vary based on your insurance plan's coverage. Before any scheduled service, please contact your insurance provider to confirm coverage under your plan and that Spencer Hospital is a participating provider under your plan.
If you do not have insurance, the estimate reflects the hospital's discounts for uninsured patients.
Or, Contact Us for An Estimate
Healthcare pricing and insurance procedures can be complicated. The best way to understand your payment obligation is to seek information prior to receiving a service. You’re welcome to contact a Spencer Hospital Financial Counselor if you’d like to review and discuss estimated charges and how the charges could affect your financial obligations later. An estimate is based on routine services. Care needs can vary based on each patient’s particular circumstances, so actual charges may be more or less than an estimate provided.
A Financial Counselor can also discuss payment options with you, to include discounts, assistance programs and payment plans for which you may qualify. For a service estimate or to learn about payment options, simply call (712) 264-8300 and dial extension 6128 or 6259 for assistance.
Pricing Resources Available
Consistent with a commitment to be transparent about pricing practices, following are resources that share information about Spencer Hospital’s charges. Click the following link to view or download a list of our standard charges and/or service bundles:
The "Standard Charges" file lists pricing information for individual services. The "Service Bundles" list includes the hospital's most common inpatient episodes of care for a specific diagnosis and are listed by Diagnostic Related Groups, known as DRGs. Both of these files are in .txt format, per regulatory requirements, which means the files are machine-readable, enabling users to view on multiple devices and operating systems.
Please understand that hospital charge levels are typically not a good indicator of what your final hospital financial obligation will be. The payment practices of your insurance company and your choice of insurance coverage is a much better indicator of what you will pay. Accordingly, if you seek a better understanding of financial obligations associated with a service at Spencer Hospital, you’re encouraged to contact one of our Financial Counselors prior to receiving your care.
Your Rights and Protection Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balanced billing.
Surprise Medical Bills FAQs
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.
Emergency services
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out- of-pocket limit.
If you believe you’ve been wrongly billed, you may contact 1-800-985-3059.
Visit www.cms.gov/nosurprises for more information about your rights under federal law.
Good Faith Estimate
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.
- Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.