Price Transparency

Frequently Asked Questions

• How does Rochester Regional Health communicate with patients about our charges and patients out of pocket responsibility?

  Rochester Regional Health has a consumer pricing hotline, (585) 922-COST, in an effort to provide our consumers with a better understanding of what charges and out of pocket payment (cost) they could incur for the specific procedure or service they are having rendered. 

  In addition, our website includes information about how to obtain information regarding our pricing; as well as information on our financial assistance program. 

• How does Rochester Regional Health set its pricing?

  We realize health care is expensive and RRH strives to hold down costs. Pricing is based on the cost of the service provided, including all resources (i.e. staff, equipment, etc.) required to provide the care. We use a consistent methodology for developing prices for all procedures and services.

• How does Rochester Regional compare to other hospitals’ charges for procedures?

  Our charges are comparable to other providers in the Greater Rochester and Finger Lakes area. 

• Why is pricing different from one hospital to another?

  A hospital’s list of charges is individual to each hospital and is based upon the hospital’s pricing methodology.  The pricing methodology can be based upon multiple factors including, but not limited to, cost, third party arrangements, and/or market considerations.

• As a consumer, what number should I be inquiring about? Charge price? Patient responsibility? Other?

  Charge prices do not reflect what is actually paid by an insurance company or what is due from a patient.

  Based upon direct customer feedback, consumers want to know what they are required to pay out of pocket for their care. As such, our focus and philosophy for pricing transparency is to provide to our patients, upon request, an estimate of what their out-of-pocket patient responsibility (cost) will be, rather than the charge price.

• How does posting charges on your website affect patients? How can consumers be better prepared before having a procedure?

  The RRH price transparency philosophy focuses on one-on-one communication to allow for a quote for a specific procedure or service at RRH, based upon that patient’s individual insurance plan for the specific procedure or service they expect to have rendered.

  The Rochester Regional’s Consumer Pricing Hotline can be reached by calling 922- COST (2678) Monday – Friday, 8:30-5:00 pm.

• What is the difference between self-pay costs and costs with insurance?
  The price a patient pays for healthcare services depends on the health insurance they have. The patient’s specific health plan coverage (deductible, copayment and coinsurance) determine how much the patient and insurance will pay. Government insurers, including Medicare and Medicaid, use a system of standardized payments to reimburse hospitals for specific services. Non-government (Commercial) insurers, including Excellus and MVP, negotiate specific payment amounts with each individual hospital and procedure.
• What is a cost estimate?

  An estimate is the predicted dollar amount that represents a patient's possible out of pocket expense for a specific service. The estimates are based on CPT codes, which are associated to the specific service a patient will receive, and the location where services will be rendered.

  Uninsured patients: The estimate will reflect the hospital's self-pay rate for uninsured patients.

  Insured patients: The estimate will reflect the patient's current benefits as provided by the insurance company at the time of the request (including deductible, co-payment and co-insurance information).

• How do I verify if a procedure is covered under my insurance plan?

  Contact your insurance company using the number on the back of your insurance card.

• How much do I have to pay at the time of service?

  Our standard procedure is to request the co-payment or a portion of the patient responsibility at the time of service.

• Does RRH offer financial assistance?

  Yes, financial assistance information can be requested by phone (585) 922-1001 or email [email protected]. Applications are reviewed on a case by case basis and may take up to 30 business days to complete.

• How can I set up a payment plan?

  Patients may set up payment plans once they receive their finalized statement for their visit. They may call our customer service team Monday – Friday 8:00 am to 5:00 pm at (585) 922-1900.

• Who can I contact with questions regarding my bill?

  Please contact our Customer Service team at (585) 922-1900 with any billing questions.

• Definitions of key terms for health care costs
  • Cost – The amount a patient pays out of pocket for health care services
  • Charges or Price – The fee(s) assessed for hospital and professional services provided.
  • Reimbursement – A payment made by a third party to the hospital and/or physician (insurance company or government payor) for each service delivered at time of service. This may also be a per diem rate or per each hospitalization episode the patient endures.
  • Current Procedural Terminology (CPT) – A five-digit medical code used to report medical, surgical and diagnostic procedures and services to entities such as physicians, health insurance companies and facilities.
  • Deductible – set amount determined by insurance provider based upon the patient’s health insurance plan.
  • Co-payment – set amount by service type determined by insurance provider based upon the patient’s health insurance plan.
  • Co-insurance – set percentage, determined by insurance provider based upon the patient’s health insurance plan