NGHS is committed to improving the health of the community in all we do – and that includes financial health in addition to physical and mental health. It is important for you to understand how much you might be charged for a visit, test or surgery, and we offer several ways to get a price estimate for most services and procedures so you can plan ahead.
Remember, final costs may vary due to insurance coverage and your unique course of care. Refer to our list of accepted insurance plans to be sure your plan is accepted for care at NGHS.
Estimates typically reflect a range of what costs can be predicted for the services you receive from the hospital, and they are based on the information you can provide. The estimate quoted is for hospital charges only and is based on benefits provided by your insurance company for the surgery or procedure your physician has scheduled for you. You may receive additional bills for pathology, anesthesia, physician services and any other services needed that are not reflected in the estimate.
Estimates can be provided for several types of care such as surgical procedures, radiology and cardiology exams, as well as rehab care and other hospital procedures. In cases where the patient does not have insurance, they may qualify for the NGHS Financial Assistance Program.
The information provided in a price estimate represents our best efforts to estimate your out-of-pocket costs based on what we know about your current insurance benefits and the services planned. It is not a guarantee of what you will be charged. There are many variables that can affect your actual out-of-pocket costs, including the length of time spent in surgery or recovery, specific equipment used, supplies and medications needed, additional tests required by your physician, any special care or unexpected conditions or complications that may arise and changes to your insurance coverage.
The costs for healthcare services generally include hospital charges and physician or clinical professional charges. The estimates provided by phone and in our online Price Estimator Tool include only hospital charges and do NOT include all physician charges, such as anesthesiologist, emergency room physician, radiologist, pathologist, etc. You should contact your physicians’ offices for pricing and coverage information related to their services.
It is important to know that there is no way to predict the exact final cost without knowing every service used during your care. This is something that can only be calculated at the end of your visit after all the other services are added up – and because of this, estimates rarely match the final cost. The amount you will ultimately pay for your healthcare services is dependent on the terms and coverage of your health insurance plan. Please call your insurance company directly at the number on the back of your insurance card to confirm your coverage for any needed healthcare services.
To request an estimate, contact our Patient Access Service Center at 770-219-7678 weekdays from 7 a.m. to 5:30 p.m. You can also use the MyChart Price Estimator to see estimates for our shoppable services and some of our most frequently priced services. The MyChart Price Estimator tool does not contain all the services provided by NGHS, but only a subset of the most common services. For information about services not included in the estimator tool, please contact our Patient Access Service Center.
To make sure your estimate is as accurate as possible, tell the doctor or provider who ordered your procedure that you need the following information to get a price estimate:
- The technical name of the surgery, procedure or other service you’re receiving
- Associated CPT codes and insurance codes provided by your physician
- Any necessary tests or services you will need before or after
- Insurance policy information including the payer/plan name, subscriber information, and policy number
Please call the number on the back of your insurance card to obtain the following information before using the MyChart Price Estimator. It is important to note that if the information listed below is not correct, your estimate will not be accurate.
- Insurance policy information including the payer/plan name, subscriber information, and policy number
- Remaining deductible amount
- Remaining maximum out of pocket amount
- Co-insurance amount
- Co-pay (if applicable to the service)
If you do not know how to find this information, please call our Patient Access Service Center and speak to one of our representatives at 770-219-7678.
Pricing Transparency
Northeast Georgia Health System complies with Centers for Medicare & Medicaid Services rules regarding price transparency by providing a machine-readable file that includes our Chargemaster, a list of our standard charges, and disclosures compliant with regulation found at 45 C.F.R. § 180.50. Because this information is specific to regulation, the information included may not be directly comparable to information from other public or private reports, databases, or documents. NGHS will update this information at least annually.
Standard charge information is updated and effective as of July 1, 2024:
It’s important to note that these documents do not reflect what patients are typically responsible for paying. We always recommend contacting our Patient Access Service Center to request an estimate for a specific surgery, procedure or service to better understand your financial responsibility.
Yes, at Northeast Georgia Health system we believe that no one should skip needed medical care because of cost. Our Financial Assistance Program helps patients apply for public health coverage programs and offers discounts, payment plans or free care to eligible uninsured or underinsured patients for their necessary medical care.
A shoppable service can be defined as a service that is planned for and scheduled before the procedure. The MyChart Price Estimator includes a list of most of our shoppable services, but it is important to remember that not everything we offer is included in this tool.
A Chargemaster is a list of all standard gross charges for each inpatient and outpatient service offered by NGHS. This includes tests, exams, procedures, room charges, and more. Chargemaster amounts are billed to insurance, Medicare or Medicaid and are rarely ever billed to patients.
Every patient is charged the same amount for the exact same service, but each patient’s care – and the total cost of all services – will vary depending on:
- How long it takes to perform the service
- How long you stay in the hospital
- The setting and location of the procedure or service
- Whether the procedure or surgery is more or less complicated than expected
- Whether any additional treatment is needed
- Any health conditions you have that could affect your care
The information in the Chargemaster is usually not the most helpful way for patients to estimate how much their healthcare services will cost them out of pocket. The Chargemaster list is not the exact amount that the customer will ultimately pay. If you have health insurance, you will receive a Statement of Benefits from your insurance carrier. The Statement of Benefits outlines any payments owed for services after the negotiated discounts and benefit plan terms are applied to your charges. In addition, you may be eligible for reduced costs from the NGHS Financial Assistance Program.
Yes, all prices are the same at every NGHS Hospital (Gainesville, Barrow, Braselton and Lumpkin).