How Hospital Pricing Works

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If you have ever needed to visit the hospital for any reason, then you are already familiar with how complex the billing process can be. Different insurance companies will cover different expenses, and every one of them for different reasons, and there is also the added complications of your income and previous health history, and what procedures, if any, were performed on you. With so many factors to take into account, you might be wondering exactly how hospitals determine what you will be billed for. If you are, then this is what you should know:


For every hospital, there is a very detailed and thorough guide to determine what a patient will be charged for. This is called the chargemaster, and it is what each hospital in America uses to bill its patients. While it might sound like nothing more than a simple list, the chargemaster is quite complicated and is consistently updated. The easiest method for an analyst to view and use this list is to use chargemaster software, which allows an analyst to break the guide down and properly process the hospital’s invoices. There are several versions of this software available, allowing you to choose the one that best suits your needs, should you require one.

Further Guidance

Since the process of using the chargemaster can be so complex, the analyst or the department that uses it will likely need further help. When a hospital is looking to purchase new software, they look for the companies that also offer help with using that software. From management teams to several forms of analyses, they guide each hospital through the process to ensure the hospital follows all protocols and regulations, and avoids any hiccups in its revenue stream. Thankfully, the worrying task of using the chargemaster is made a little easier because of companies like those.