Resources to help understand and compare health care costs

At Children’s Minnesota, we agree that talking about the cost of health care is important. Listed below are several resources to help patient families understand and compare costs that may appear on your billing statements from Children’s Minnesota.

For a glossary of billing and insurance terms, go here.

Children’s Minnesota cost estimate

For the most accurate estimate for the cost of care, patient families can contact Children’s Minnesota at [email protected] or call 952-992-5627 for assistance in understanding the charges and related costs for a procedure or visit. You will need to provide some basic information, which is listed on the Billing and financial matters page under “How can I find out ahead of time what something will cost?”

‘Minnesota Hospital Price Check’ tool

The Minnesota Hospital Price Check tool from Minnesota Hospital Association allows you to compare up to three Minnesota hospitals at a time, including information about average procedure charges, length of stay and other details.

Children’s Minnesota 300 shoppable services

CMS price transparency

To help understand the price of most common services at our facilities, all U.S. hospitals and health systems are required to provide a list or an electronic tool that can assist families with receiving this cost information. Below is a link to our online price estimator tool that will provide you with this information. The tool will be able to provide you with your specific insurance cost. Please have your insurance information ready before you begin. You can contact us at [email protected] or call 952-992-5627 for additional assistance.

Go here for our price estimator tool

Children’s Minnesota standard charges

CMS price transparency

To improve price transparency, all U.S. hospitals and health systems are required to provide lists of standard hospital charges ― also called a “chargemaster” ― so patients can compare prices across hospitals.

• Children’s Minnesota hospital facility chargemaster
• Children’s Minnesota professional list of standard charges (chargemaster)
• Children’s Minnesota ambulatory/Minnetonka standard list of charges (chargemaster)
• Children’s clinic network community clinics (eCW) standard list of charges (chargemaster)

Here are a few considerations to keep in mind as you view the chargemasters:

• Charges are rarely the price that patients pay. The chargemaster lists the dollar amount set for each service prior to insurance contract/benefit plan discounts or self-pay discounts being applied, so the price patients pay tends to be less than the standard charge.
• Hospital charges differ from patient to patient for the same service depending upon variations in treatment.
• Patients who are eligible for financial assistance also receive additional discounts.
• Items included in a charge vary across hospital systems. For example, what’s included in one hospital’s charge for room and board may differ from other hospital’s charge ― some hospitals bundle services together into a single charge that others may list separately.
• Looking at various hospital charges does not provide any indication of quality of service and outcomes.
• Procedures performed at a pediatric hospital, like Children’s Minnesota, have different requirements than similar procedures performed elsewhere on adults. That’s because caring for children is different, and providing specialty pediatric care includes higher nurse-to-patient ratios, specific equipment designed for children, longer recovery times for kids vs. adults, and wrap-around care for children and families.

Children’s Minnesota de-identified minimum and maximum negotiated payment and payer-specific negotiated payment by type of patient group

CMS price transparency

All hospitals and health systems are required to provide a listing of the minimum and maximum negotiated payment for all payers combined, not specifically identifying any payer (de-identified) along with payer specific negotiated payments.

View the Children’s Minnesota list of de-identified minimum and maximum negotiated and payer specific negotiated payment by type of patient group (MS-DRGs).

Please contact us at [email protected] or call 952-992-5627 for negotiated payment information related to outpatient or clinic services.

Discounted cash price

CMS price transparency

All hospitals and health systems are required to post the discounted cash price for services. However, Children’s Minnesota does not provide a discounted rate for individuals who pay cash. Our list of charges included in the section above of standard charges is our price. Please refer to our financial assistance policies for additional information if you need help paying your bill.

Get more information about financial counseling and assistance here.

Children’s Minnesota top 25 primary care prices

Minnesota price transparency

All Minnesota primary care providers also are required to post a list of their top 25 most common preventive care services and procedures costing more than $25, along with the corresponding prices for each of those services. This list includes four amounts for each procedure: the providers’ charge, the average commercial reimbursement rate, the Medicare allowable payment rate and the Medicaid allowable payment rate.

As with the list of standard hospital charges discussed above, the prices on the primary care procedures list represent the standard amount for each service prior to insurance contract/benefit plan discounts or self-pay discounts being applied. What a patient actually pays will depend on their unique benefit plan terms.

View the Children’s Minnesota lists of top 25 primary care services over $25:

• Community-based primary care clinics (Partners in Pediatrics, Hugo, West St. Paul)
• Hospital-based primary care clinics (Minneapolis, St. Paul)

Hospital-based clinic fee disclosure

Go here for a list of clinics that are part of a hospital.

Depending on your health insurance, you may see additional charges on your Children’s Minnesota billing statement. These include:

1. A facility fee from the hospital. This includes support staff, supplies and building expenses.
2. A provider fee for your medical provider’s services.

Please check with your insurance provider to understand your costs as you may be responsible for additional out-of-pocket expenses.

For questions about your bill, contact the Children’s Minnesota billing office at 952-992-5650.

For an estimate for the cost of care or financial assistance, contact a Children’s Minnesota financial counselor at 612-813-6432.

Go here for more information about hospital-based clinic billing.

Protections against surprise medical bills

• Your rights and protections against surprise medical bills
• Your right to receive a Good Faith Estimate of expected charges for self-pay and uninsured

For more information on the No Surprises Act, visit the CMS.gov website.

Access a .txt version of this information: childrensmn.org/price_transparency.txt