Note that "charges" are not what patients actually pay. A patient's out-of-pocket cost will be determined by their insurance plan coverage. Uninsured patients or those that cannot afford their portion of a bill can contact Patient Financial Services at (716) 601-3600 for assistance.
Pricing Terms and Information
The dollar amount set for each service rendered, prior to any insurance contract or self-pay discounts taken. For regulatory purposes, hospitals must submit full charges when processing claims. However, the charges have no direct relation to the reimbursement the hospital receives nor the out-of-pocket cost for the patient.
A patient’s out-of-pocket cost is a combination of co-payments, deductible, and co-insurance determined by their specific insurance plan. Patients should consult their insurance company to better understand their plan and covered services. Uninsured patients are eligible for financial assistance and should contact our Patient Financial Services team at (716) 601-3600 for more information.
Insurance Allowable/Contracted Amount
Private insurers set their payment rates through direct negotiations with hospitals and determine the hospital’s reimbursement for services. Government insurers such as Medicaid and Medicare determine rates paid to individual hospitals.
The set amount which your insurance company expects you to pay upon each visit for a specified service.
The set amount you have to pay each year before your insurance plan starts paying benefits.
A certain percentage of a service your insurance company requires you to pay and which is paid after you reach your deductible on covered services.
Centers for Medicare & Medicaid Services (CMS) Prospective Payment System Final Rule (CMS-1694-F)
In compliance with Regulation CMS-1694-F, Catholic Health is providing a list containing our charges for items and services provided and a list of charges by Diagnostic Related Group (DRG). The hospital’s charges are the same for all patients. However, a patient’s responsibility may vary, depending on rates negotiated with health insurance companies and out-of-pocket cost (see above definition). Uninsured or underinsured patients should contact our Patient Financial Services Team at (716) 601-3600 to determine whether they qualify for one of our assistance programs.
Please review the definitions above for more information on the difference between charges, prices, and your out-of-pocket responsibility.