Understanding Costs

Truman Medical Center (TMC) is interested in helping you understand the costs associated with your health care. TMC is listing the charge price (CDM) for the procedures and services we perform. The charges contained in TMC’s CDM are the same for all patients. However, the charges in the CDM do not reflect TMC’s actual reimbursement from patients or insurance companies. TMC’s actual reimbursement is influenced by a variety of internal and external factors, including negotiated health plan rates, fixed government rates, individually negotiated package pricing, fixed fund distributions for indigent care populations, prompt payment discounts and self-pay patients. Other factors affecting reimbursement could include whether a procedure was performed on an inpatient or outpatient basis, physician orders, comorbidities and complications, medical necessity and specialty services and procedures. If you are comparing TMC’s CDM to the CDMs of other hospitals, it is important to note that descriptions and charges contained in the CDMs may vary from hospital to hospital. Among the reasons for this variance, are that different hospitals may include different goods, supplies or procedures under a similarly named description. Items or services that are special ordered by a physician are typically not included in room or procedure charges. Most treatments or services provided by ancillary department staff, such as respiratory therapy, laboratory, rehabilitation, pharmacy, etc., are separate distinct services that we are required to bill separately. TMC does not employ many of the physicians that may provide services within TMC. Charges for most physician services are not included in the CDM.

Understanding Costs (Excel Spreadsheet)

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