About Us

The word “verity” refers to the state of being true. For all of us associated with Verity Health System, that means we will be authentic in our interactions with our patients, their family members and with each other. We choose to align ourselves with the following values, aspiring to live into these values each day so that they may guide our actions.

Respect

We demonstrate that we value others and ourselves through our words and actions.

Caring

We provide our patients and their families with compassionate, quality care, treating them and each other with kindness.

Integrity

We act with honesty and transparency and do the right thing.

Passion

We are dedicated to making a difference in the health of our communities and in the lives of those we serve.

Stewardship

We are committed to being wise stewards of our resources, creative in our approach to challenges and opportunities, and accountable for the results we want to achieve as a charitable organization.

Effective January 1, 2019, in an effort to “improve the transparency of hospital charges”, the Center for Medicare Services (CMS) has mandated that all facilities participating in the Medicare and Medicaid programs “make public a list of their standard charges” via the internet [CMS-1694-F].

Verity Health Systems gladly support this effort and is therefore providing this information to our patients by posting our price files for our facility charges on this site. Please note that the prices in the file reflect the hospital’s full charges, which do not take into account:

• Medicare, Medi-Cal and other government health care program reimbursement rates;
• Contract rates with health maintenance organizations (HMOs) and health insurers;
• Other privately negotiated discounts; and
• Hospital community benefit and charity care programs that provide care free of charge.

The charge description master (CDM) price files, Seton Medical Center and Seton Coastside, contains the hospital’s full charges for each item and service that the hospital provides. However, third party payers (for example, Medicare and Medi-Cal) do not necessarily pay the hospital on the basis of the CDM. Instead, they pay based on procedure or illness on the basis of a diagnosis-related group (DRG). These DRGs generally include multiple items and services listed on the CDM. A list of DRGs and an explanation of the items and services included in each DRG is included in the DRG file/available at www.cms.gov/ICD10Manual/version34-fullcode-cms/fullcode_cms/P0001.html.

The CDM file consists of charges related to all services including supplies, devices, vaccines, radiopharmaceuticals, room accommodation charge codes and pharmaceuticals of patients in the Verity Health Care Systems network.

The Price File contains the following elements:

• Procedure Charge Number – A unique identifier within the system for each chargeable item.
• Procedure Description Name – a brief description of the service being provided
• CPT^® (Current Procedural Terminology) or HCPCS (Healthcare Common Procedure Coding System) code – this is a nationally recognized alphanumeric code utilized by the insurance industry and government payors to identify a particular service or item.
• Unit Price – The gross dollar amount charged for each item to the account

Variable prices may be present for services such as Reference Lab testing, implanted devices and items/services governed by other contracted rates. These prices may not be available for listing in the CDM since billed charges are based upon the charges invoiced by the contractor to Verity Health Systems at the time the service is provided.

Pharmaceutical prices listed are acquisition cost based. These costs may vary depending upon many factors such as date purchased and supplier. The patient may, therefore, see multiple prices for what appears to be the same medication. In practice, depending upon the dosage ordered by the provider, a patient may see multiple units of a single medication listed on a claim. The total of these units represents the total dosage provided to the patient. CHARGE GENERATION

Individual departments within Verity Health Systems may generate charges through an electronic charge or order communication system. Most charging information for a patient admission or encounter

originates from the CDM. The charges, charge descriptions, and all codes attached to a line item in the CDM, flow through electronic systems to Patient Financial Services (PFS), where corresponding claims are generated. The claims may be edited before submission to the appropriate payors based upon contractual terms.

The total charges listed for a particular encounter or admission may not necessarily represent the total payment expected by Verity Health Systems. The expected payment amount will vary based upon contractual arrangements between Verity Health Systems and the various payors, the insurance plan in which the patient is enrolled and other special programs for which the patient may apply and be found eligible for. We encourage you to contact our Patient Financial Services Department to assist you in estimating what your out-of-pocket expenses will be for a particular procedure.

• View the Seton Medical Center Price File.
• View the Seton Coastside Price File.

CPT^® is copyright 2018 American Medical Association. All Rights Reserved. The CPT® data provided in this list is only approved & licensed for use for the approved KnowledgeSource user only. Any other use of this output or use of CPT® in any other product requires a separate license. Use of this product should not be accepted as proof of license for CPT® Editorial content by any other vendor for any other product. Please contact us for purchase of full CPT® Data files and licenses used in separate PAS or products

 

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