Shoppable services consist of our most utilized outpatient services, as well as a predetermined set of 70 services selected by Centers for Medicare & Medicaid Services (CMS). For each service, total charges expected to be billed are displayed to allow consumers to make more informed health care decisions.
Hospital charges are regulated by the Maryland Health Services Cost Review Commission (HSCRC), a state regulatory agency. The HSCRC sets average hospital rates every year, and normally twice per year effective January 1 and July 1 of each year through a Rate Order for the hospital. These rates will be updated on our website each time UPMC Western Maryland receives a new rate order from the HSCRC.
All payers, patients and insurers, pay Maryland hospitals on the basis of the rates established by the HSCRC. This means there are no payer negotiated rates for hospital services, only select discounts made available under the Code of Maryland Regulations (COMAR). Under COMAR 10.37.10.26 (http://mdrules.elaws.us/comar/10.37.10.26); a patient shall receive a 2-percent discount by paying upon discharge or a 1-percent discount by paying within 30 days of discharge while commercial payers are entitled to a 2-percent (calculated on discharges) or 2.25-percent (calculated on admissions) discount for making working capital deposits with the hospital.
The total charge listed for a service includes what you can expect to be charged for a service from both the hospital (hospital charge) and hospital employed physician (professional charge) where applicable. Hospital charges are calculated using estimated volumes at current HSCRC approved rates where appropriate. Your actual charges will vary based upon numerous factors, including but not limited to, your actual surgical time used and overall health condition. Due to the structure of hospital charging in Maryland, each individual encounter is billed uniquely. Please consult with your service provider to understand the expected professional charge for your service.
Patients seeking an estimate of their out of pocket amount that you will be expected to pay for receiving health care services should contact the hospital business office at 240-964-8435. If you need help paying your health care costs, please see the Financial Assistance section under the Patients and Visitors tab on the website for more information on financial assistance, screening for medical assistance, and payment plans. Please note, a patient’s financial obligation is determined by many factors, including insurance coverage and benefit plan limits.