Medical West is committed to delivering the best care possible and providing our patients the information you need to make good decisions about your health care. Our goal is to provide patients with high quality care and the best possible experience, from registration through discharge.
We know that understanding billing, insurance and medical records may seem overwhelming at times. To make this process more transparent and help our patients understand their personal out-of-pocket responsibility, Medical West offers a direct line to speak with a financial counselor that will be happy to walk you through your expected costs and how much you may be responsible for paying depending on your insurance coverage and deductible.
For more detailed information about the costs associated with a specific procedure, please view our list of charges* or call our financial counselor at (205) 481-8605 Monday – Friday, 8AM – 4:30 PM for a more detailed estimate of your out-of-pocket expenses.
When calling our financial counseling hotline for an estimate – you will need the following three items for an accurate estimate of your out-of-pocket expenses:
- Detailed description of the test(s)/procedure(s) being ordered by the doctor.
- Doctor’s name and office phone number,
- Insurance information (if any), including insurance company name and phone number, policy holder name, policy number and group number located on the insurance card.
How Are Prices Determined?
Pricing for health care services and what you are ultimately charged depends on many factors. In addition to the basic pricing for the treatment or procedure you undergo at the hospital, your bill may include additional amounts for things such as anesthesia, medical equipment, facility use, lab tests, certain medications, radiology services, supplies, provider charges, and care involving unexpected conditions or complications based upon individual health at the time of service.
How Are Prices Calculated, and How Are Out-of-Pocket Costs Determined?
Pricing for services delivered by a hospital begins with the Charge Description Master, a price listing for all hospital items and services available to hospital personnel as they deliver patient care. All items and services used during the course of a patient’s treatment are summarized on a bill, which represents the total price of all items and services used during a patient’s treatment.
If a patient has health insurance coverage, hospital bills are first submitted to the insurance company for initial payment. The insurance company would pay for hospital services based on the negotiated contract with the hospital and the patient’s purchased insurance plan benefits. If the total balance was not satisfied by the insurance company, the hospital could seek payment from the patient, which would represent the patient’s out-of-pocket cost.
For patients who do not have health insurance coverage, Medical West has developed a cash price for services, including a balance adjustment similar to that experienced by a patient with purchased health insurance coverage. This adjustment seeks to provide some financial fairness for patients who do not have access to or the ability to afford purchased health insurance coverage.
Calculating out-of-pocket costs is often difficult, given all the factors that can impact a patient’s bill. The best way to find out is to ask. Thanks to current technology, Medical West can assist with estimating out-of-pocket costs for many of our most common services. This allows patients to better understand individual out-of-pocket costs and to satisfy that responsibility prior to receiving treatment. Medical West also recommends talking directly to your health insurance provider to better understand policy and benefit coverage and how much could be owed for a specific treatment or service.
Keep in mind that the more complex or long-term the care is, the harder it becomes to estimate costs upfront – especially if unexpected complications or other health care needs arise.
Please use the links below to access the Medical West listing of standard charges and the online patient price estimator tool:
Where Can I Get More Information about Medical West Hospital Costs?
For more information about our pricing and your specific charges, please call 205-481-8605 to speak with a financial counselor.
How Much Does a COVID-19 Test Cost at Medical West?
For patients with insurance coverage who wish to pay out of pocket for a COVID-19 test, or for those with no insurance, Medical West offers cash-based pricing. Please click on the link below to see pricing information on COVID-19 testing at UAB.
*These amounts represent the usual and customary charges billed. They are not necessarily an estimate of amounts due. For a more detailed estimate of the out-of-pocket costs associated with services, please contact your health insurance plan or call our patient estimate line at (205) 481-8605.
No Surprise Billing
If you do not have insurance or do not intend to file a claim with your insurance, you have the right to receive a Good Faith Estimate for the total expected costs of any non-emergency services received at Medical West.
- You have the right to receive a Good Faith Estimate for the total expected costs of any non-emergency items or services.
- You have the right to receive a Good Faith Estimate verbally or in writing at least one business day prior to your non-emergency medical service or item.
- If you receive a bill that is at least $400 or more than your Good Faith Estimate, you have the right to dispute the bill with Medical West.
- You have the right to take a picture or request a copy of your Good Faith Estimate for your personal records.
- You have the right to discuss healthcare service options with your insurance plan, specifically regarding a list of in-network facilities and providers. Please see your insurance card for more details on how to contact your plan.
When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise or balance billing. See terms below:
- Balance Bill: When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, or a deductible. You may receive additional costs or must pay the entire bill if you see a provider or visit a health facility that isn’t in your health plan’s network.
- Out-Of-Network: Providers or healthcare facilities that have not signed a contract with your insurance plan to provide services.
- Surprise Billing: An unexpected balance bill. A surprise bill can happen when you cannot control who is involved in your care. For example, when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network Physician or other healthcare provider.
When are you protected from Balance Billing?
- In instances of emergency services performed in an out-of-network facility or by an out-of-network provider, you cannot be balance billed for the services. The most you can be subject to pay is your plan’s in-network cost-sharing amount – such as copayments or coinsurance.
- When you receive services from an in-network facility, certain physicians or healthcare providers may be out-of-network with your insurance plan. In these situations, these out-of-network physicians or healthcare providers may not balance bill you. The most you can be subject to pay is your plan’s in-network cost-sharing amount – such as copayments or coinsurance. This applies to healthcare providers from emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalists, or intensivist services. These providers cannot balance bill you and cannot ask you to forego your rights under the No Surprise Billing Act.
You’re never required to give-up your protections from balance billing. You also aren’t required to receive care out-of-network. You have a choice to select a provider or facility that is in-network with your insurance plan.
Questions about your rights and protections:
Contact the Alabama Department of Insurance at (334) 269-3550.
More information about your rights and protections:
Contact (800) 985-3059 or visit https://www.cms.gov/nosurprises/consumers for more information about your rights under federal law.
For Good Faith Estimate Disputes or other questions:
Contact the Medical West Customer Service Team at (205) 481-7121.