In compliance with state law, Institute for Orthopaedic Surgery is providing this price list containing our charges for room and board, operating room, physical therapy and other procedures. The hospital's charges are the same for all patients, but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients should consult with our admitting and billing staff to determine whether they qualify for discounts. Anesthesiology, pathology and physician fees are not included. Rates for each individual service can be obtained from the provider of service. IOS does not charge interest on unpaid accounts. These prices are correct as of January, 2010.

Room and Board -- Per Day Charges
	Charges
Orthopaedic	848.72

Operating Room Charges
Operating Room charges are based on the complexity level, with level 1 being the most basic, for a particular operation There is an initial, set-up charge as well as an additional charge for each 30 minutes while the operation is being performed.
	Set-Up Charge	Additional 30-Minute Charge
Level 1	1697.82	175.05
Level 2	3068.91	408.45
Level 3	3768.17	583.50
Level 4	4726.31	700.19
Level 5	6024.15	816.89

Physical Therapy
The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.
EVAL BY PT (41-60 MIN)	179.71
THERAPEUTIC EXERCISE W/PT (15 MIN)	69.11

Occupational Therapy Charges
The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services performed.
EVAL BY OT (41-60 MIN)	179.71
ADL TRAINING (15 MIN)	69.11
WOUND CARE	151.71

Hospital Billing Policies

It is the policy of the Institute for Orthopaedic Surgery (IOS) that payment is due when services are rendered. As a service, IOS will submit for patient third party claims. Any patient “self-pay” portion is due within thirty (30) days of receipt of the service. [For purposes of definition: “self-pay” portion is defined as non-covered services, copayments, and deductibles.] IOS will submit claims to insurance companies according to established guidelines. Complete billing information must be presented at the time of registration and/or admission. IOS reserves the right, where agreements with the payer are not to the contrary, to determine the length of time before the account becomes the responsibility of the patient and their guarantor due to the lack of timely payment from the insurance company. At no time, unless agreed to with the insurance company to the contrary, will an anticipated insurance payment override the patient's obligation to pay the balance outstanding. IOS will make its best effort to notify patients of the insurance benefits verified by the patient's insurance company within three (3) working days of the hospital's receipt of the insurance benefits verification. Patients and guarantors may request an itemized bill by contacting a representative of the Accounts Receivable Department. IOS does not routinely send an itemized bill to the patient. The guarantor will receive a monthly statement that provides an account status and lists any activity occurring since the last statement. Every effort will be made to assure that every patient account statement is accurate and easily understood by "lay persons". If you have specific questions about your account, our Customer Service Representatives are available Monday through Thursday, 8:00 a.m. to 5:00 p.m. and Friday, 8:00 a.m. to 4:30 p.m. Spanish speaking representatives are also available. We repeatedly offer patients access to financial help during their hospital stay and after, as well as with each billing notice. We send bills to collection as a last resort, only: When patients have the ability to pay some portion of their healthcare expenses but refuse to do so. When patients refuse to work with us to determine if they qualify for free or discounted care via federal, state, local or hospital assistance programs. When we are unable to locate the patient or the person responsible for the bill. INSTITUTE FOR ORTHOPAEDIC SURGERY does not currently charge interest on amounts not paid in full. Download a PDF of our Pricing Information Consumers can access a number of government and private Websites, which provide additional information on hospitals' charges and quality. For a complete listing of available online resources, please visit the Consumer's Guide to Quality Health Care in Ohio at www.ohanet.org.