Effective Date: January 1, 2021

Hospital Transparency Introduction and Footnotes

Introduction:

The Centers for Medicare & Medicaid Services (CMS) guidance requires that Saint Peter’s University Hospital provide clear, accessible pricing information about the items and services we provide in two formats:

• Comprehensive machine-readable file with all items and services
• Display of shoppable services in a consumer-friendly format

The intent of providing this information is to assist you in determining your individual out-of-pocket costs (patient responsibility amounts) for services you receive at Saint Peter’s.

Files:

221487330_Saint Peters University Hospital_shoppable services

LISTINGS:

The following listings provide the link to our standard charges:

• 221487330_Saint-Peters-University-Hospital_standardcharges
• 221487330_Saint-Peters-University Hospital_Standard-Pharmacy Charges 1.1.2024

Footnotes:

To assist you in this process, we are also providing you with the following instructions, footnotes and limitations:

1. You as the patient and/or guarantor are responsible for reviewing your policy to ensure that Saint Peter’s University Hospital is within your provider network.
2. You as the patient and/or guarantor are responsible for reviewing your policy to determine your specific patient responsibility provisions – deductibles, co-payments and co-insurance.
3. The charges, rates and fees identified were effective as of January 1, 2021 and are required to be adjusted annually. 
4. The charge amounts are estimates based on a selected sample of similar services provided for that defined service.  Implants and High Cost Drug estimates(?) may or may not be included depending on the Payer. The use of Implants and High Cost Drugs are specific to the actual services required and will vary based on the actual services received.
5. Services provided by Clinicians are not included in the charges, rates and fees. These providers bill separately for their own charges for services and receive payment directly for those services.
6. Newborn charges and fee estimates are based on a single birth.

Definitions:

1. Standard Charges / Payment Types:
   1. Gross Charge – the charge for an individual item or service that is reflected on a hospital’s chargemaster, absent any discount.
   2. Discounted Cash Price – the charge that applies to an individual who pays cash or cash equivalent for an item or service.
   3. Payer-specific Negotiated Charge – the charge that a hospital has negotiated with a third-party payer for an item or service.
   4. Per Case - a payment methodology in which a single payment is made applicable to all covered services rendered during an entire Admission or an Outpatient Encounter.
   5. Per Day – a payment methodology in which a single payment is made applicable to all covered services rendered each day of an Admission.
   6. Per Visit – a payment methodology in which a payment for a covered service rendered on one-calendar day period.
   7. Per Unit – a payment methodology in which a payment for each unit of a covered service rendered.
   8. De-identified Maximum Negotiated Charge – the highest charge that a hospital has negotiated with all third-party payers for an item or service. 
   9. De-identified Minimum Negotiated Charge – the lowest charge that a hospital has negotiated with all third-party payers for an item or service.  
2. Shoppable Service – a service that can be scheduled by a healthcare consumer in advance.
3. Ancillary Item or Service – any item or service a hospital customarily provides as part of or in conjunction with a shoppable primary service and may or may not include laboratory, radiology, drugs, operating room, recovery room, etc.
4. Service Package – is an aggregation of individual items and services into a single service for which the hospital has a single standard charge.