Surgical Care Improvement

Part of our continuing efforts at improving quality is participation in national initiatives for public reporting of quality measures promoted by the Centers for Medicare and Medicaid Services (CMS).

Process of care measures show how often hospitals give recommended treatments known to get the best results for certain surgical procedures. Information about these treatments is taken from the patients’ records and converted into a percentage. This is one way to compare the quality of care that hospitals give.

SSCBR extracts data and submits the information to CMS for the applicable process of care measures for the Hospital Inpatient and Outpatient Quality Reporting Programs. These are specific sets of guidelines for the treatment of surgical patients and the prevention of surgical site infections and other adverse events. Research has shown that following these guidelines leads to significantly better outcomes for patients.

The results indicate how well a hospital is doing in following specific guidelines as a percentage of applicable cases and provides a comparison to the national average. 

In compliance with federal law, SSCBR provides a list of standard charges for hospital services (the “Fee Schedule”). The Fee Schedule does not represent the actual amount paid by any governmental or commercial insurance providers, nor does it represent that actual amount for which a patient may be responsible. Each patient’s financial responsibility may vary. The actual amount a patient pays is based on many factors, including health insurance, benefit plans, other applicable discounts, and the services provided based on the patient’s individual needs.

To obtain the most accurate estimate of patient out of pocket costs, it strongly recommended that patients contact their insurer to request an estimate or SSCBR's Admission's Department at (225) 408-5661. To obtain the most accurate estimate possible, the patient’s insurance information, if any, as well as a specific description of the service requested, preferably a physician’s order, are necessary.

We also advise patients to consult, as applicable, with his or her health insurer to confirm individual payment responsibilities and remaining deductible balances.

Although estimates are available through SSCBR for most scheduled services, the nature of healthcare, including the factors described above, dictates that the appropriate level of care, and thus the patient’s cost of that care, frequently cannot be accurately determined until the care has actually been provided.

The actual cost for which the insurance and/or patient may be responsible are often, although not always, significantly less than the total charges posted to a patient’s account, and thus, estimating payer cost or patient responsibility using a fee schedule alone will not produce an accurate estimate.

By Accessing This Fee Schedule, You Are Acknowledging The Following: 

I have read and am aware of the above information, the contextual limitations of the SSCBR Fee Schedules and recognize that the SSCBR Fee Schedules cannot be used as a single source for determining actual cost to any payer, including insurers, employers, or patient out-of-pocket responsibility, and if such single service determination is attempted, the information will be out-of-context and therefore, incomplete and inaccurate. I understand that the list of charges reflects the standard charges for services provided at SSCBR. I understand that the Fee Schedule includes hospital services only and does not contain professional fees for any physicians or other medical practitioners, lab charges, diagnostic services or other related costs that are not included as hospital services. I understand that the prices on the Fee Schedule are the prices of hospital charges and do not necessarily represent the amount my insurance company will pay or what I will owe.

If I am a non-patient, third-party, I acknowledge that I have read and am aware of the above information, the contextual limitations of the SSCBR Fee Schedules, and recognize that the SSCBR Fee Schedules cannot be used as a single source for determining actual cost to any payer, including insurers, employers, or patient out-of-pocket responsibility, and if such single service determination is attempted, the information will be out-of-context and therefore, incomplete and inaccurate. I further acknowledge that if I or my organization republish, post online, or otherwise re-communicate this information to another party and hold-out these fee schedules to the sole determining factor in establishing payer cost or patient out-of-pocket responsibility, without providing the contextual limitations described above, I risk misleading the consumers of such information due to the limitations detailed in this disclaimer. If my or my organization’s intent is to aid a payer or patient in determining actual payer cost or patient out-of-pocket responsibility, I acknowledge that this intent is most accurately and effectively achieved by recommending that such individuals contact their insurer or SSCBR's Admissions Department at (225) 408-5661.

THIS SITE AND THE FEE SCHEDULE IS STRICTLY AN ESTIMATE OF CHARGES AND SSCBR CANNOT GUARANTEE THE ESTIMATES BECAUSE SERVICES RENDERED TO EACH PATIENT AND THEIR COST MAY VARY BECAUSE OF TREATMENT DECISIONS, UNFORESEEN COMPLICATION, ADDITIONAL TESTS OR SERVICES ORDERED BY YOUR PHYSICIAN, AND THE INDIVIDUAL NEEDS OF EACH PATIENT. THIS SITE AND THE INFORMATION CONTAINED IN THE FEE SCHEDULE IS FOR INFORMATIONAL PURPOSES ONLY AND IS NOT AN OFFER OR REPRESENTATION OF THE PROVISION OF MEDICAL SERVICES.