Cancer Treatment Centers of America® (CTCA), Chicago, has always been committed to empowering our patients by ensuring they have the information they need to make informed health care decisions and is proud to share a full list of our health care charges.
At CTCA® Chicago, we know that cancer patients are as unique as the cancer they are fighting. That means the care our patients receive from their physician-led care teams is tailored to their respective needs. To obtain the most accurate estimate of the patient out of pocket costs, it is strongly recommended that patients contact their insurer to request an estimate based upon your specific health insurance plan. Actual cost to the patient, as well as the out-of-pocket (OOP) amount for which a patient will be directly responsible are determined by several factors and are not in the exclusive control of CTCA® Chicago.
Key considerations as you explore CTCA’s charges include the following:
- The payment methodology applied by the patient’s insurance, which may include commercial health insurance, automobile insurance, workers compensation insurance, or government health insurance coverage, e.g. such as Medicare, Medicaid, or Veterans Administration, etc.
- These insurance payment methodologies, including the prospective payment methodologies applied by Medicare and Medicaid, frequently are not directly related to fee schedules charges or a percentage of charges,
- The patient’s level of coverage, particular insurance plan (e.g. HMO, PPO, etc.), network participation status of each provider, and the patient’s currently outstanding benefits within the patient’s plan benefit package, including co-pays, co-insurance, remaining deductible, and OOP maximum,
- The most appropriate services, as determined by the patient’s treating and/or referring physician(s) at the time they receive the services, and acknowledging that the patient’s actual medical need, as determined be the treating physician at the time of service, may be substantially different than the anticipated medical need prior to provision of the medical treatment or services.
- Although estimates are available through CTCA® Chicago for most scheduled service, the nature of healthcare, including the factors described above, dictates that the appropriate level of care, and thus patient OOP cost of that care, frequently cannot be accurately determined until the care has actually been provided.
- The actual cost for which the insurance and/or patient may be responsible are often, although not always, significantly less than the total charges posted to a patient’s account, and thus, estimating payer cost or patient OOP responsibility using a fee schedule alone will not produce an accurate estimate.
As always, we remain focused on delivering high-quality oncology services with the same Mother Standard® of care our patients have come to expect, and continually seek more efficient and cost-effective ways to do so in today’s increasingly challenging health care environment.
