Estimate Options & Transparency
Learn about cost estimate options and our commitment to transparency.
What is a price estimate?
Many patients want to know what their care will cost before it happens. We can help with several ways for you to receive a price estimate. A price estimate is the predicted cost of your care. It is based on the procedures that you expect to receive.
A price estimate is not a guarantee. Your charges may be higher or lower, depending on:
- The actual services you receive in consultation with your doctor.
- Whether you have health insurance and if the treatment is covered by your plan.
- How much your health insurer says your share of the costs is.
To understand your financial responsibility, it's important that you contact your insurance company once your provider has told you the procedures likely to be performed.
Get a price estimate from UW Medicine
Price estimates for self-pay patients are auto generated typically within three (3) days of your scheduled visit. For all other estimates, call the location where you are seeking care to request an estimate:
- Harborview and UW Medical Center: Contact the Financial Access Clearance Team at 206.598.4388
- UW Medicine Primary Care: Contact your clinic or call 206.520.5000
- If you are permanently residing outside of the United States and seeking nonemergent services, please visit our UW Medicine International Program as the first step to help you navigate the process.
If you cannot pay the patient responsibility portion of your bill, Financial Counselors can assist with applying for Financial Assistance, Medicaid, Apple Health programs and Washington Health Benefit Exchange. For out of state Medicaid and Exchange programs resources can be provided. Call UW Medicine Financial Counseling to schedule an appointment at 206.744.3084.
Price transparency
The Centers for Medicare and Medicaid Services (CMS) requires hospitals to make a list of standard hospital charges public via the Internet. CMS defines "standard charge" to mean the regular rate established by the hospital for an item or service provided to a specific group of paying patients.
The information in these files is updated at least annually and complies with CMS requirements for machine-readable files. To meet these requirements, these files include multiple charging components.
Learn more about Price Transparency and download CMS files »
No Surprises Act
Effective 1/1/2022, the Federal No Surprises Act ("FNSA"), applies a broader scope of plans and services than Washington's BBPA. Combined they offer transparency and disclosure for individuals seeking medical services.
Click here to learn more about your right to receive a Good Faith Estimate. Under the law, health care providers must give patients who don’t have insurance or who are not using insurance an estimate of the bill for the health care items and services they are about to receive. A Good Faith Estimate provides transparency for the total expected cost when scheduling or upon request.
About hospital-based clinics
A hospital-based clinic is a department of the hospital. This type of clinic also is called a hospital-based outpatient clinic or provider-based clinic. Because it must follow the same strict government rules for safety and quality as hospitals, it is more complex and costly to operate. When you see a health care provider or receive services in a hospital-based clinic, you are receiving care that meets hospital standards.
To help understand your bills, here are the answers to some of the questions patients often ask.
Will I pay more for services at a hospital-based clinic?
Depending on your health insurance coverage, you may pay more for some outpatient services and procedures at hospital-based clinics. A hospital-based clinic is licensed as part of the hospital and the patient may receive a separate charge for the facility, which may result in a higher out-of-pocket expense.
Patients are responsible for co-payments, coinsurance or deductible amounts for both professional and facility charges after insurance has paid. We recommend you calling your health insurance provider to determine what your out-of-pocket expenses will be, if any, before receiving service.
What do I need to know as a Medicare patient?
Medicare (out-of-pocket) costs are based on Medicare’s prescribed rates for each of the two charges: hospital/facility and physician/professional. Medicare patients have a higher coinsurance amount for services at a hospital-based facility.
What do I need to know as a Commercial or Medicare Advantage patient?
Insurance plans vary. Please call your health insurance provider.
Ask your health insurance company:
- Does my insurance benefit plan cover hospital/facility charges in a hospital-based outpatient clinic?
- How much of the charge is covered?
- How much will be applied to the deductible?
- How much will I owe out-of-pocket (coinsurance) after meeting the deductible?
How can I receive a price estimate?
For insured patients, price estimates are available upon request prior to your visit or procedure:
- Harborview and UW Medical Center contact Financial Access Clearance Team at 206.598.4388.
- UW Medicine Primary Care contact your clinic or the appointment line at 206.520.5000.
What types of charges will appear on my bill?
For transparency, provider (professional) and facility (hospital) charges will be itemized on your bill by your care location. The provider/professional are charges from the care received from your provider. The facility/hospital charges include items such as equipment, supplies, non-clinical staff time, and building costs.
Where can I call with my financial questions or concerns?
If you have questions about a bill you have received, please call Patient Account and Support Services at 206.520.0400 or 855.520.0400. If you have questions about insurance coverage, please contact your health insurance provider.