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Carolinas Healthcare System Blue Ridge is committed to empowering patients, in partnership with their care team, to make informed decisions about their healthcare. This includes helping patients understand the cost of their care, as well as financial assistance that may be available.
In compliance with federal law, Carolinas Healthcare System Blue Ridge provides a list of standard charges. As part of the FY 2019 Medicare Inpatient Prospective Payment System rulemaking, CMS updated its guidelines to require hospitals to post a list of their current standard charges via the internet in a machine-readable format. This information must be updated at least annually.
The list charge of a hospital service is not equivalent to the actual amount paid by governmental or commercial insurance companies; accordingly, each patient’s financial responsibility may vary. The amount a patient pays is based on many factors, including health insurance, benefit plans and other applicable discounts, and the services provided based on each patient’s unique needs.
Carolinas Healthcare System Blue Ridge reviews our hospital charges annually to ensure they accurately reflect the high-quality care we seek to provide. In some cases, our charges are different from other providers when we offer a higher level of care and unique clinical expertise. Overall, Carolinas Healthcare System Blue Ridge works with patients, providers and partners to lower the cost of care through wellness, disease management and quality care.
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Resources for Consumers
Carolinas Healthcare System Blue Ridge Average Charges by MS-DRG are available here: .CSV version - PDF version
The NC Division of Health Service Regulation requires that all NC hospitals report charging and payment information for the Top 100 Inpatient DRGs, Top 20 Outpatient Surgical Procedures and Top 20 Outpatient Imaging Procedures:
https://www2.ncdhhs.gov/dhsr/ahc/hb834/https://www2.ncdhhs.gov/dhsr/ahc/hb834/search.asp
The Healthcare Financial Management Association (HFMA), in collaboration with the American Hospital Association (AHA) and America’s Health Insurance Plans (AHIP), provides resources to assist healthcare consumers understand healthcare prices as well as avoid surprise medical bills:
https://www.hfma.org/consumerguide/
The Centers for Medicare and Medicaid Services (CMS) provides the following Frequently Asked Questions (FAQs) documents as a resource for further clarification of the requirements:
Frequently Asked Questions Regarding Requirements for Hospitals To Make Public a List of Their Standard Charges via the Internet
Additional Frequently Asked Questions Regarding Requirements for Hospitals To Make Public a List of Their Standard Charges via the Internet