HOSPITAL RATE SCHEDULE

Transcription

1 HOSPITAL RATE SCHEDULE Questions? Call Financial Services at: x 4833 OHIP PATIENT UNINSURED RESIDENTS & UNINSURED SERVICES NON-RESIDENTS OF CANADA (VISITORS) OH UR OC Inpatient Daily Charges: Acute Care Daily Rate - Standard Ward - $1,688 $2,602 - Newborn - $487 $825 Rehabilitation Daily Rate Chronic -Standard Ward - $377 $604 Inpatient Cosmetic Daily Rate (excludes Procedure & Devices) - Standard Ward n/a $1,578 $2,525 Preferred Accommodation (daily rates): (a) Acute or Rehab. Semi-Private $230 $230 $230 Private $265 $265 $265 (b) Chronic Semi-Private $35 $35 $35 Private $55 $55 $55 Outpatient Visit Charges: Day Surgery (DS) Visit - $1,292 $2,385 Emergency Room Visit Out-Patient Clinic Visit Out-Patient Follow-up Visit with specific treatment Hand Clinic (incl Physio/Occupational Therapy) Chemotherapy Visit (excluding drugs) Diagnostic Services (Radiology, ECG etc.) Computer Axial Tomography (CT) - $1,544 $2,647 - $817 $1,400 MRI - $811 $1,431 Laboratory Visit - $140 $280 Outpatient Cosmetic Daily Rate (excludes Procedure & Devices) - Standard Ward n/a $1,292 $2,385 Ambulance (Ministry of Health) - Essential ($195 covered by OHIP) $45 $240 $240 - Non-Essential $240 $240 $240 Patient Transport (Private) - to patient residence min $130 min $130 min $130 (call for quote) When quoting a Delisted Procedure (not covered by OHIP), always refer to the Delisted Rate Schedule or contact Finance at extension 4833 for assistance. IN-PATIENT: The rate of $ includes recovery and In-Patient time, however excludes Medical Equipment, Rentals and Physician Charges. Note: for Uninsured and Out of Country (OC) residents CT charges are extra.

2 DELISTED / UNINSURED RATES Delisted / Uninsured Services are procedures that are no longer covered by OHIP. Cost of the procedure is the responsibility of the patient. Rates are subject to change without notice. Rates include HST and exclude Physician Charges. Description Circumcision - Newborn less than 3 months (In-patient or Out-patient) Residents of Canada Non-Residents of Canada $214 $430 Circumcision - Adult or Child (In-patient or Out-patient) Cord Blood Retrieval fee (maternity) Vasectomy/Tubal ligation reversal (Out-patient) Vasectomy/Tubal ligation reversal (In-patient ward) Tattoo Removal (exception: abuse or POW) (Out-patient) Repair of deformed earlobes (Out-patient) Removal of acne pimples Removal of benign skin lesions not clinically suspected of disease or malignancy (Papilloma, Spider Naevus, Keratoses or any lesion removed for cosmetic reasons only - Out-patient) Varicose Veins (simple): Injection (including compression - Out-patient) CATARACT LENS RATES BASIC LENS: AcrySof SA Upgrade: AcrySof IQ Upgrade: AcrySof IQToric IOLs SN6AT2,SN6AT3,SN6AT4,SN6AT5,SN6AT6,SN6AT7,SN6AT8,SN6AT9 Upgrade: AcrySof IQ ReSTOR Multifocal IOLs SN6AD1,SV25T0 Upgrade: AcrySof IQ ReSTOR Multifocal Toric IOLs SND1T2, SND1T3, SND1T4, SND1T5 $104 $104 $1,292 $2,385 $1,688 per day $2,602 per day RESIDENTS of CANADA (OHIP) Uninsured Residents and Out-Of-Country Visitors no charge $160 $80 $180 $510 $610 $890 $990 $1,185 $1,285 Note: For all out-of-country & uninsured patients the Day Surgery visit fee is over & above the Lens rate Patients are expected to Bring their Receipt of Payment on the day of Surgery

3 MEDICAL DEVICES & OTHER CHARGES Rates are subject to change without notice. Rates include HST and exclude Physician Charges. Description Abdominal Binder Aerochamber - adult (blue) Aerochamber - child (yellow) / infant paediatric (orange) Ankle Brace (aircast) Athletic Supporter Cane Cast Shoe Clavicle Splint (small/medium/large/extra large) Crutches Diapers or Wipes All inpatient or outpatient medical devices are chargeable. Medical devices provided as a part of a patient s care are billable whether or not the device is taken home. All devices are non-refundable. Note to clerk: The below devices are to be entered into the OE Meditech system once the device has been given to the patient. Patient Charge $ 50 ea $ 32 ea $ 54 ea $ 95 ea $ 23 ea $ 27 ea $ 63 ea $ 30 ea $ 44 pair $ 13 pack $ 77 ea Elbow Splint Finger Splint (with bulb/without bulb) $ 5 ea Foam Walker - Short (Anklizer II) $ 90 ea Foam Walker (small / medium / larger / extra large) $ 138 ea Foam Walker - VACOCAST (small / medium / large) $ 149 ea Foot Brace - Navigait (Small, Large/XL) $ 97 ea Foot Brace LEFT or RIGHT: A-60 Aircast (Medium or Large) $ 85 ea Hip Protector $ 82 ea Hospital provided medication (to go) $ 9 pack Humeral Fracture Brace (small / large) $ 149 ea ICE Wrap $ 74 ea Incentive Spirometer $ 27 ea Knee Immobilizer - large $ 61 ea Knee Immobilizer - medium $ 57 ea Knee Immobilizer - small $ 53 ea Paediatric Wrist Splint $ 27 ea Philadelphia (Cervical) Collar - extra small / small / medium / large $ 96 ea Ploycast-wrist/hand/thumb $ 97 ea Range of Motion - Leg Brace $ 183 ea Range of Motion - Walker $ 181 ea Shoulder Immobilizer - paediatric $ 13 ea Shoulder Immobilizer - small/large $ 24 ea Soft Cervical Collar - 3 inch $ 20 ea Soft Cervical Collar - 4 inch $ 25 ea Sole Sensor Insole $ 27 ea Surgical Boot T.E.D. Stockings Tensor Volar (Wrist) Splint Wrist Brace (small / medium / large) Wrist D-ring - with thumb Wrist D-ring - without thumb Questions? Contact Financial Services: ext $ 25 ea $ 38 pair $ 5 ea $ 20 ea $ 41 ea $ 46 ea $ 37 ea

4 Leg Cast - Walking Full Leg Club Feet Stovepipe Cast Bodycast - Jacket FIBREGLASS CAST RATES Description Wrist Cast/Scaphoid (Short Arm) Full Arm Knee Cast - NWB Below Knee Knee Cast - Walking Below Knee Leg Cast - NWB Full Leg Questions? Contact Financial Services: ext Amount for Amount for Child ($) Adult ($) $41 $48 $48 $64 $59 $81 $64 $102 $75 $102 $81 $107 $48 N/A $64 $86 $81 $107 Above charges apply to both In-Patient and Out-Patient Services

5 OTHER CHARGES and Billing Notes DEPOSITS Prepayment of patient charges is required when services to be provided by the Hospital to a patient are not insured. The deposit requested will be one half of the expected stay with a minimum deposit of one day's stay. AUTOPSIES (HST NOT APPLICABLE) Autopsy on deaths, which occur outside the Hospital and are deemed Non-Coroners cases, will be charged a Facility fee and Professional fee totalling $1,550. REFUSING DISCHARGE FROM HOSPITAL After a discharge order has been written, a charge of $1,707.59/day will be levied until a discharge plan is established and agreed upon. This charge does not include a levy for preferred accommodation, which is separate, but does include the alternate level of care co-payment charge. CO-PAYMENT FEES: Applies to Complex Care (CC) patients ALTERNATE LEVEL OF CARE (ALC)/Restorative/End of Life/Medically Complex A co-payment charge will be levied for: Complex Care patients receiving medically complex care, restorative care or end of life care services Alternate level of care patients waiting for a complex care or long term care bed The charge is currently a maximum of $56.93 per day to a maximum of $1, per month (effective July 1, 2014). This charge is set by the Ministry of Health and Long Term Care and updated annually. TRANSPORTATION COSTS Patients that have been discharged and require third party non-emergent transportation will be charged a minimum fee and, if applicable, a surcharge for distance travelled. It is recommended for patients and/or their families to arrange for transport and payment directly with respective vendors. Patients and/or their families are to be notified of the charge when the transportation is arranged by the hospital. This is an uninsured service and an administration fee applies should the hospital facilitate transport and invoicing on behalf of the patient. NOT SUFFICIENT FUNDS (NSF) - CHEQUES A charge of $20.00 will be levied in regards to NSF cheques. INTERNET Wi-Fi ACCESS Available from the Gift Shop (ext 5587) Hours: 9:30am - 8:00pm The charge for internet Wi/Fi access is as follows: 24 hour period: $10 1 week period: $20 1 month period: $35

6 OTHER CHARGES and Billing Notes RELEASE OF INFORMATION Health Records Routine Service - Personal Requests (includes all personal and legal requests): Insurance Companies: Demand Service (within 24 hours - additional charge): All of the above charges are to a maximum of 20 pages, each additional page is 25 cents. $30 $160 $200 Supervising an individual's examination of an original record: $27 per hour ($6.75 for each 15 mins) per hour rate Making and providing a paper copy of a record from microfilm or microfiche: $0.50 per page, plus standard processing fees Making and providing a record on disk: $10, plus standard processing fees Research requests for Chart retrieval (per chart): $0.50 $10 + $5 Human Resources Third Party requests: $200 Requests for confirmation position of employment from previous employees (dates employed, status, hours worked): Former Employees whose termination date falls on, or after January 1, 2000: Routine Service (within two weeks): Demand Service (within 24 hours): $50 additional cost Former Employees whose termination date falls on, or before December 31, 1999: Routine Service (within two weeks): Demand Service (within 24 hours): $100 additional cost $25 $50 $75 $100 Cheques must be provided at time of request and made Payable to: Joseph Brant Hospital. If unable to confirm employment, due to lack of records, no fee will be charged. Note: rates subject to change without notice For any other inquiries related to patient charges, please contact the Financial Services department at ext.4833