Pacific Grove Hospital is committed to helping our patients regain hope and continue their recovery journey by delivering excellent patient care. Whether you are searching for the right treatment option for yourself, a family member, or friend, we support price transparency and believe it is important to have the information necessary to make informed choices when choosing a healthcare provider.
We’ve established 3 easy ways for you to obtain the information you need to estimate your financial responsibility if you are currently seeking or scheduling care.
A call or email will connect you with an admissions specialist who will be happy to provide you an estimate of your financial responsibility after your insurance company pays their portion, or provide you additional information about our self-pay discounts, charity care policy, and additional payment plan options.
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On this page, we’ve also provided a link to our hospital charge list for our services. We realize looking at a list of charges can be overwhelming, so we are providing some definitions and information to help frame understanding of what the charge list is and what the charge list is not:
Charge: The dollar amount assigned to a specific healthcare service before negotiating any discounts with payors. The charge is different from the price. Very few patients pay the charge regardless of their insurance status; and, therefore, this data is not meaningful to people.
Cost: The definition of cost varies by the party who is incurring the expense: To the patient, cost is the amount payable out of pocket for health care services. To the provider, cost is the expense (direct and indirect) incurred when delivering health care services to our patients. To the insurer, cost is the amount payable to the provider or reimbursable to the patient. To the employer, cost is the expense related to providing health benefits.
Out-of-Pocket: Portion of the total price for healthcare services and treatment for which the patient is responsible. This includes copayments, coinsurance, and deductibles.
Price: The negotiated and contracted amount providers expect to be paid by payers (also called the “allowed amount”). Your out-of-pocket liability is based on this allowed amount. Note that the price for a service will vary by insurance plan as these are separately negotiated.
What the Charge list is: The standard charge list is strictly related to the Charge for a service. Hospitals are typically paid based on contracted rates for the services they provide, so the Charge will not reflect the amount paid by your insurance or the amount due from you. Your coverage, co-payments and deductibles are specific to your insurance plan.
What the Charge list is not: The standard charge list is not an exact estimate of your Out-of-Pocket cost and does not represent the Price paid to the hospital or Cost incurred by the hospital. Please note that while we have standard Charges that are the same for each patient, the final Cost, Price, or Out-of-Pocket cost may vary depending on your insurance plan or whether you quality for financial assistance. Please contact us at (951) 330-3649 or firstname.lastname@example.org and we will be happy to provide you an estimate of your financial responsibility after your insurance company pays their portion, or provide you additional information about our self-pay discounts, charity care policy, and additional payment plan options.
Please also note: the charge list may not include:
- The information contained in the file is current as of the last upload. Charge information is subject to periodic changes and the file will be updated as soon as practically possible to reflect such changes
- The file contains both the charge amount, the charge code, and the charge description of the item or service as reflected in the hospital’s chargemaster
- The charge list may not include fees for Professional Services (ex. Psychiatrists, Psychologists, other Professional Providers); Laboratory Expenses ordered by your Physician; or Pharmacy Expenses which will vary by the medication dosage prescribed by your Physician.
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