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Estimate Your Out-of Pocket Cost

   

Chippewa Valley Hospital is pleased to offer a good faith estimate to provide you with better clarity and understanding of your health care investment in advance of services. For a personalized cost estimate, choose one of the following options.

  1. Click on the Estimate Request Form link and complete the online form. If you have insurance, you will need to have your insurance card available. A written or verbal estimate will be provided to you within two business days.
  2. Call (715) 672-4211. If you have insurance, you will need to have your insurance card available. A written or verbal estimate will be provided to you within two business days.

Questions to Ask Your Doctor Prior to Requesting an Estimate

  • What is the exact name of the procedure(s)?
    • Ask the doctor to clearly write out the name of the procedure. Correct spelling is important since many surgery names sound similar.
  • What CPT code(s) will be used for the procedure(s)?
    • CPT codes are the billing codes used by providers for physician services. If you do not have this, please be sure to have the exact name of the procedure.
  • What ICD-9 diagnosis code(s) will be used?
    • The International Classification of Diseases codes identify your health condition and allow health care professionals anywhere in the country to have a shared understanding of conditions.
  • Will you be staying overnight?
    • Does the doctor expect that you will be admitted to the hospital as an inpatient overnight, or that you will be treated on an outpatient basis?
  • In addition, be sure to have the first and last name of the doctor who ordered the procedure. For surgical procedures, please provide the surgeon’s first and last name.