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listing on billing statements for many individual procedures
involving a medical supply based on a schedule of algorithms that
typically are a multiple of the cost of the supply item used or a
multiple of the average wholesale price of the pharmacy item
used.
At discharge, patients are furnished a summary bill that
shows separate charge categories such as patient room charges,
pharmacy, medical/surgical supplies, and laboratory. Upon
request, the patient will receive a more detailed bill that
itemizes each separate charge within the broad categories. The
items listed on summary bills vary from patient to patient based
on the exact medical care received by the patient. For example,
the bill often identifies charges as being for the use of patient
rooms and for various special areas, such as the operating room,
recovery room, delivery room, nursery, emergency room, or
intensive care unit. The bill also may identify charges for
ancillary procedures such as radiology, anesthesia, nuclear
medicine, various laboratory procedures, inhalation therapy, and
physical therapy. Some specific charges on the detailed bill are
identified by the name and/or code of a particular medication,
supply item, or IV solution used in providing medical services to
the patient.
Public or private insurance programs directly or indirectly
pay 70 and 80 percent of the hospitals’ bills to patients. Those
insurance programs calculate payments to the hospitals on a flat
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