The information provided in this tool is intended for personal informational
purposes only and is in compliance with Fiscal Year 2019 Medicare Hospital
Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital
(LTCH) Prospective Payment System Final Rule (CMS-1694-F). The prices listed
are Novant Health hospital charges only and do not include any physician
fees or other non-hospital facility charges. I understand the charges do not
reflect my actual out-of-pocket healthcare costs determined by my health plan
design, deductibles, co-insurance, and out of pocket maximum amounts.
Uninsured or underinsured patients may qualify for financial assistance based
on the Novant Health Charity Care Policy. I am aware that I should contact
Novant Health Financial Navigators toll-free at 1-888-277-3901 in NC
and 703-369-8020 in Northern VA or 540-829-4320 in Culpeper, VA to learn more
about how much I will pay for a service.
