A deadline is looming for hospitals that wish to stay in good graces with federal agencies.
Early this year, Seema Verma, administrator for the Centers for Medicare and Medicaid Services, announced new rules that require hospitals to post their standard prices online and to make it easier for patients to access electronic records.
The new rules take effect Tuesday, said Deidra Ashley, a member of the MU Health Care public relations team.
"We will meet the requirement to post charges online starting Jan. 1, 2019," she said in an email.
In Jefferson City, Capital Region Medical Center already meets rate-posting requirements, said Lindsay Huhman, the medical center's director of marketing.
"Capital Region Medical Center has publicly posted estimated charges for outpatient services for about two years," she said in an email.
Go to crmc.org/patients-and-visitors/billing-insurance/pricing-transparency to find rates. Once there, you can click on links that show charges for daily room and board, emergency charges, X-rays and many other categories.
The website assures users the hospital wishes to help patients take full advantage of their insurance coverage and bills insurance - including Medicare and Medicaid - before billing the patients. Patients are not charged interest on balances after insurance payments are received, according to the site.
Charges are "gross charges" and "no one pays gross charges," according to the site. People receive discounts for their insurance and those who have no insurance are billed only 35 percent of charges, according to the site.
Typically, the hospital charge is $2,200 per day for room and board for patients who stay in the intensive care unit, $731 per day for rehabilitation and $318 per day for obstetrics. It includes rates for other types of overnight stays.
Emergency room charges vary, depending on the level of service required.
The site lists charges for more than 40 of the hospital's most common X-ray procedures. Among them are "ankle," $550.20; "chest, one view," $475.65; "skull, complete," $268.80; and "hand, three view," $365.
The site even has a list of the average costs for a long list of conditions or procedures, generated from October 2017 to this past September.
MU Health Care provides online charts of estimated costs of procedures (including discounts for uninsured or "self-pay" patients). Those procedures include CT scans, MRI, X-ray, ultrasound, lab tests and many other screenings and procedures.
With the discounts, a tonsillectomy for a child under 12 is $3,554.83 and for someone older is $3,699.06; a colonoscopy and biopsy together are $2,239.49; an unattended sleep study at home is $389.20; and fragmentation of a kidney stone is $5,013.49.
Patients in the next couple of days will be able to access St. Mary's Hospital's standard charges by clicking on the "price estimate" link at the foot of its web page. From there, visitors can navigate to another page that includes a drop-down menu for standard charges for the hospital, said Patrick Wood, a communication and marketing consultant for St. Mary's Hospital.
"In compliance with federal law, SSM Health will be providing a list of standard charges for each of our ministries, including SSM Health St. Mary's Hospital-Jefferson City, effective Jan. 1, 2019," Wood said in an email. "However, it's important to note that standard charges of hospital services are not equivalent to the actual amount paid by governmental or commercial insurance payers. Instead, the amount a patient pays is based on many factors, including health insurance, benefit plans and other applicable discounts, as well as the services provided based on each patient's unique needs."
Even when the costs are available online, the hospital recommends consumers call (844) 989-6292 for an "accurate and personalized" estimate.
Many prices for procedures at St. Mary's Hospital may be found on the Missouri Hospital Association's (MHA) website, focusonhospitals.com, which includes information from all Missouri hospitals. Helping hospitals comply with state law, it provides prices for the 100 most common medical procedures hospitals perform - and includes quality outcomes.
With Tuesday's changes, hospitals are required to place the cost information in a format computers can easily process. However, it may still be confusing to consumers, since standard rates are like list prices and don't reflect what insurers and government programs pay, Verma said when she announced the rule.
Patients concerned about their potential out-of-pocket costs from a hospitalization are still advised to consult with their insurer. Most insurance plans have an annual limit on how much patients must pay in copays and deductibles - although traditional Medicare does not.
The MHA is helping area hospitals comply with new federal requirements, Huhman said. Mary Becker, its senior vice president of strategic partnerships and communications, said the MHA tries to provide guidance to hospitals when Missouri or the federal government issue new rules.
"Hospital pricing is difficult," Becker said. "Missouri hospitals have made a good faith effort to provide both quality and pricing information to the public for nearly three years (before state law required it)."
Posting data on the MHA website helped hospitals comply with the state law, she said, but the new federal law requires too much data and information for its website to meet the requirement.