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Price Transparency

Getting Ready

In 2013, the Arizona State Legislature approved HB 2045, which requires hospitals and healthcare providers with more than 50 beds to make available to the public, upon request, the Direct Pay Price for their 50 most used Diagnosis Related Group (DRG) codes. The Direct Pay Price is the price that Phoenix Children's charges for the identified service, regardless of the patient’s health insurance status, if the service is paid for directly, in full, either by a patient (directly or through a Health Savings Account) or by the patient’s employer (for instance, through a self-insured plan).

Health Care is Complicated

We understand that health care – and health care pricing – is complicated. Here’s some information that will help you understand the information provided:

APR-DRG

All Patient Refined Diagnosis Related Groups (APR-DRG) categories were created by 3MTM in a joint effort with the Children’s Hospital Association, to create consistency among children’s hospitals, allowing us to track outcomes as well as costs.

A patient is first assigned to a base APR-DRG (e.g.: APR 139, Other Pneumonia) similar to the assignment of a Medicare-based MS-DRG. This assignment is based primarily on the patient diagnosis but takes into account several other factors as well.

Subclasses

The patient is then separately assigned two distinct subclasses: severity of illness (SOI) and risk of mortality (ROM). SOI is defined as the extent of organ system derangement or physical decompensation for a patient.

Each subclass has four possible assignment levels:

  1. Minor
  2. Moderate
  3. Major
  4. Extreme

The SOI class provides a basis for evaluating hospital resource use or to establish patient care guidelines. Patients are assigned their SOI based on their specific diagnoses and procedures performed during their inpatient hospital stay. Patients with higher SOI (e.g. major or extreme) are more likely to consume greater health care resources and stay longer in hospitals than patients with lower SOI in the same DRG.

If you come to Phoenix Children’s and you have a medical emergency or are in labor, you have the right to receive, within the capabilities of Phoenix Children’s staff and facilities, an appropriate Medical Screening Examination, necessary stabilizing treatment (including treatment for an unborn child) and, if necessary, an appropriate transfer to another facility even if you cannot pay or do not have medical insurance.

Phoenix Children's 50 Most Used Inpatient Diagnosis-Related Groups Codes
Phoenix Children's 50 Most Used Outpatient Services Codes

What’s the cost for my child’s care?

Because every child is different, our Financial Counselors are happy to talk with you about your child’s individual needs. Upon request, they will work with you to provide a personalized estimate of charges in advance of care.

We’re here to help

Our commitment is to ensure you understand the financial assistance processes at Phoenix Children's.  If you still have questions, please contact our Financial Counseling department at 602-933-2000.

Learn more about our Financial Assistance Policy

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