If you would like a price estimate for another health care service, please call a patient financial services representative at 406-632-4351.
You must first agree to the Disclaimer outlined below before you can view our pricing information. Thank you.
My Cost – Disclaimer Agreement
| The estimated charges provided on the following pages are intended to give patients an estimate of the prices and payments for the more commonly provided health care services at Wheatland Memorial Healthcare and Bair Memorial Clinic in Harlowton, Montana. This information is an estimate only and is in no way a quote or a guarantee of the amount that you will owe or what the charges for a service will be. The estimates cannot and should not be relied on as the actual charges and/or payments you will be responsible for paying, as the actual charges and/or payments may be either lower or higher than the estimates depending upon many factors – including, but not limited to, your healthcare provider’s treatment choices, actual services rendered, complications and your particular health care needs. The estimated charges are based on the information you enter on the following pages. If you have insurance coverage, your insurance policy coverage (including deductibles, network coverage, co-pay, co-insurance and out-of-pocket maximums) will help determine the amount you owe.
The information provided on the following pages is not a contract for the actual amount patients will be required to pay. You will be held responsible for the actual amount you owe determined after services are rendered. Note: The estimated cost is not a guarantee of insurance coverage. Please check with your insurance company if you need help understanding your benefits for the service chosen.
I HAVE READ AND UNDERSTAND THE ABOVE DISCLAIMER AGREEMENT AND I FULLY UNDERSTAND THAT THE INFORMATION ON THE FOLLOWING PAGES ARE ESTIMATES ONLY. THE ACTUAL AMOUNT I WILL BE REQUIRED TO PAY MAY BE, AND LIKELY WILL BE, DIFFERENT (HIGHER OR LOWER).
I UNDERSTAND AND AGREE (Click on AGREE to go to list of standard charges) |
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