How Much Will My Care Cost?
This question is top-of-mind for many of our patients. Being transparent about the cost of your care is just one way SSM Health is improving health care. Here we provide some resources to help you make a more informed decision about your care and to help you better understand any out-of-pocket costs you may incur.
We know that navigating health care costs can be confusing, so we invite you to call us or fill out this form for a personalized price estimate. And if you need help with financing your care, we can start that conversation too. SSM Health is committed to making health care better for you.
When Calling to Request an Estimate
When calling us for a personalized price estimate, please be prepared to provide the following information to ensure a quicker response time:
- Patient name and contact information
- Patient insurance information (verify your insurance is accepted)
- Physician ordering test/procedure
- CPT code(s)
- A coding system, defined in the publication Content Procedural Terminology, for medical procedures that allows for compatibility in pricing, billing and utilization review. If you are unable to provide a CPT code for your procedure, please contact your ordering physician to obtain the code(s) in order to complete your request.
Items affecting your out-of-pocket expenses:
It is very important to verify with your insurance that this procedure is a covered benefit under your plan, requires pre-authorization, and if SSM Health is considered an in-network provider. Your insurance company will hold you liable for this information. (Our verification process does not include verifying your specific benefits). Our estimate is based on the rate, predetermined through the insurance contract. We are verifying active coverage only and possible out-of-pocket patient responsibility left at the time of the inquiry (deductible, co-insurance & copay).
- The amount of money you must pay annually before your health insurance plan begins to pay for other medical expenses.
- A cost-sharing requirement in which you are responsible for paying a certain percentage of the cost and the insurance company is responsible for the remaining percentage of the covered medical expenses after your deductible is met.
- Also known as a co-pay, this refers to a specific flat fee for each health service.
Items impacting the accuracy of the estimation of liability:
- Accuracy of CPT(s)
- Additional testing ordered
- Patient remaining for observation/in patient after a procedure
- Cost/quantity of medications
- Changes in patient deductible due to timing of insurance claims processing
Our shoppable services are available to review. Please call a customer care representative at 844-989-6292 during normal business hours so they can help you understand the services and associated charges.
Note: All estimates are an approximation of your out-of-pocket hospital billing expenses. This does not include any estimation for professional billing (physicians, pathology, radiologists, etc.). If you have detailed questions about how your insurance carrier will process your claim, please contact your insurance carrier. Any estimation of liability is not considered a guarantee of benefits (or coverage of the test under your specific insurance plan).