Price Transparency
What Main Line Health is doing to be transparent on hospital pricing
Main Line Health is committed to delivering value and high-quality care while also complying with federal laws requiring price information be made available to the public. Widespread variation in health insurance plans and associated benefits make it difficult for hospitals to provide specific price information without access to very detailed information about a patient's health insurance coverage, deductibles and co-pay arrangements.
Some of the ways in which we show our commitment to price transparency include:
- Publishing the Main Line Hospitals chargemaster, which is required by federal regulations to provide a higher level of transparency
- Financial counselors are available at each hospital and are also accessible via phone to assist patients with understanding and estimating their financial responsibility
- A dedicated Patient Estimation team is in place to help patients proactively estimate their financial obligations prior to an inpatient or outpatient service
- Main Line Hospitals have a comprehensive Financial Assistance Policy to assist certain qualifying patients with their financial obligations
- Charity Care (free care) up to three times the Federal Poverty Level is offered to patients who qualify
- Deferred payment arrangements can be made under most circumstances which are interest free
- Main Line Hospitals have partnered with AblePay Health as a payment option for medical expenses that are a patient's financial responsibility. AblePay provides savings (up to 13%), flexible payment terms, advocacy, and convenience for out of pocket medical expenses. Enroll in AblePay.
- Use of Epic's MyChart portal as a means of communicating price information to our patients is in development
To learn more, you can
- Visit our chargemaster page for more information and a list of FAQs
- Access price estimators for shoppable services
- Review our patient brochure for additional information on the billing process as well as important telephone numbers for your reference
Standard charges
Effective January 1, 2021, CMS regulation requires all hospitals to make public their standard charges for items and services provided to patients in two parts: 1) 300 shoppable services; 2) Machine-readable format.
For the machine-readable file, the links below will provide our standard charges for all items and services, including gross charge, payer-specific negotiated charges, minimum payer negotiated charge, maximum payer negotiated charge, and the self-pay price.
Things to know:
- The price listed in the published machine-readable file comes from the Charge Description Master (CDM) which is considered the Provider's "Standard Charge."
- The CDM is displayed at each single unique instance of facility, charge description, department, revenue code, Procedure Code, and price.
- In some instances, the standard charge price may be $0. This can occur when:
- The price is variable and potentially based on a cost mark-up. This is common in CDM codes for pharmacy and material/supply items.
- A payer negotiated charge for a service/procedure is "Not Separately Reimbursed."
- A service/procedure was not specified in a given contract.
- Pharmacy and supply charges:
- It is common billing practice for a single pharmacy CDM charge item to be used to bill for multiple NDCs (National Drug Codes) containing variable cost and pricing. Due to the existence of the one-to-many relationship between NDCs and CDM charge codes, a standard charge cannot be established and tied to single lines in the machine-readable file.
- Supplies, materials and devices that are priced as $0 in the CDM are assumed to have variable prices due to a one-to-many relationship assigned outside of the CDM charge code. A standard charge, therefore, cannot be established in the machine-readable file.
List of items and services by location:
Files last updated December 10, 2024