Our Commitment to Pricing Transparency
Spencer Hospital makes patient satisfaction a priority, which includes pricing transparency related to the services it offers.
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.
Anticipate Potential Separate Bills
It’s important to understand that your total charges for care received at Spencer Hospital may include expenses beyond hospital services. This can include charges from your family physician, a surgeon, radiologist, pathologist, anesthesia provider and other medical providers who supported your care. In most instances when receiving care at Spencer Hospital, these charges are not managed by the hospital and you’ll receive separate bills from the medical providers who were engaged in your care.
Insurance Coverage Is a Factor
What you pay for hospital services is also a function of the insurance coverage you’ve selected from a private insurance company (such as Wellmark) or qualify for through a government program (such a Medicare, Medicaid, the Veterans Administration or the like). Insurance payments toward your care can vary widely based on decisions you make about your coverage levels and will impact your personal financial obligation.
Another key consideration to understand what you pay for hospital services is to know how hospital “charges” work. Every hospital sets a dollar amount, a “charge,” for each of its services. A charge is similar to a list price. However, hospitals rarely are paid the full amount of those listed charges.
Here’s how it works:
After you receive care at Spencer Hospital, we’ll send your insurance company a list of charges associated with your visit.
Your insurance company will review all charges and typically applies a discount, informing the hospital the price they will allow for each service. This is due to many factors, including payment deductions by government insurance programs and discounting procedures through private insurance companies.
After the allowed charge is established, your insurance company will pay the hospital the amount allowed by your specific coverage plan. You’ll then be notified of out-of-pocket costs you are responsible for in accordance with your chosen deductible and co-payment coverage levels.
Because so many variables impact what the final cost of your services are as compared to initial charges, it’s important to understand that a listing of charges is likely not what you or your insurance plan actually pays for your healthcare.
To provide a better understanding of what you or your insurance company is actually billed for a healthcare service, Spencer Hospital has compiled a spreadsheet of its 300 most common hospital charges. For each charge, the hospital’s major payers are listed and what each company is actually paying the hospital for that service in comparison to the listed charge. Click on this link to access the spreadsheet: 42-6005883 Spencer Municipal Hospital 300 Shoppable Services Pricing Transparency File. Please note this listing does not include Medicare charges. Reimbursement for Medicare services are not negotiated, but rather are established by the federal government through the Centers for Medicare and Medicaid Services. Some Medicaid charges are listed because Iowa’s Medicaid program is outsourced by the State of Iowa to private managed care companies.
Pricing Resources Available
Consistent with a commitment to be transparent about pricing practices, following are resources that share information about Spencer Hospital’s charges:
By clicking here, you can view a listing of our “Average Charge per Diagnostic Related Group.” This is the hospital’s average total charges for an inpatient episode of care for a specific diagnosis. The file is machine-readable, so you should be able to view it on multiple devices and operating systems. If in your view, you see a cell that contains a series of hashtags - ##### - be sure to expand the cell size or click on the cell to see the numbers within the cell. Views may vary depending on the resolution and screen size of your viewing devise.
Additionally, you can click the following link to view or download a list of our standard charges: 42-6005883 Spencer Municipal Hospital Standard Charges This file is also machine-readable.
To obtain a better understanding of what your insurance provider reimburses the hospital for a service, click here to open the spreadsheet of the 300 most common Spencer Hospital charges. This lists the contract rate established with the most frequently used insurance providers: 42-6005883 Spencer Municipal Hospital 300 Shoppable Services Pricing Transparency File
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.
COVID-19 Diagnostic Laboratory Testing Price
The price of a COVID-19 lab testing (CPT 87635 and U0001) at Spencer Hospital is $96.00 or $54.00 depending on where the test is sent for processing (inclusive of supplies, lab equipment and staff time to perform the test). Many insurance companies, as well as government programs such as Medicare and Medicaid, have taken steps to ensure coverage to eliminate any out-of-pocket costs for COVID-19 testing. For any self-insured patients, there will not be a bill at this time. Spencer Hospital will seek reimbursement from any applicable government programs, which may provide coverage for the testing charges.
Click here for Copyright notice for use of UB-04 Revenue Codes.