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Short Term Acute Care HospitalVoluntary non-profit - Private

Upmc Hamot

UPMC ยท Erie, PA

201 State Street, Erie, PA 16550

28

In-network payers

250

Disclosed rate categories

423

Beds

3

Care quality

About this facility

Upmc Hamot is a 423-bed voluntary non-profit - private facility in Erie, PA, affiliated with UPMC. Below you'll find publicly disclosed negotiated rates and facility details, including 28 in-network payers and 250 disclosed rate categories.

CCN (Medicare provider number)

399817

NPI

1487647590

Type

Short Term Acute Care Hospital

Ownership

Voluntary non-profit - Private

Beds

423

Care Quality

3

Insurance Accepted

Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthEMI HealthGroup Health Cooperative of South Central Wisconsin

Negotiated Rates

The data below comes from CMS-mandated price transparency data. Learn more.

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PayerCategoryCode Type & GroupContract Typevs. State Average

Aetna

Outpatient

CPT Category II Codes

Range: 0001F - 9007F

Negotiated

Very Low

Aetna

Outpatient

CPT Category III Codes

Range: 0042T - 0810T

Negotiated

Very Low

Aetna

Outpatient

CPT Category III Codes

Range: 0042T - 0810T

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Negotiated

High

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Negotiated

Very Low

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Multianalyte Assay

Range: 0002M - 0018M

Negotiated

Low

Aetna

Outpatient

CPT Pathology and Laboratory Procedures

Range: 80047 - 89398

Negotiated

Very Low

Aetna

Outpatient

CPT Pathology and Laboratory Procedures

Range: 80047 - 89398

Percentage of Bill Charged

-

Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.

Showing 1 - 10 of 250

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Location

201 State Street, Erie, PA 16550

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Frequently asked questions

About Upmc Hamot's rates and hospital price transparency.

How many beds does Upmc Hamot have?

Upmc Hamot has 423 beds. Facility type: Short Term Acute Care Hospital.

Where is Upmc Hamot and what is its phone number?

Upmc Hamot is located at 201 State Street, Erie, PA 16550.

What is Upmc Hamot's CCN (Medicare provider number)?

Upmc Hamot's CMS Certification Number (CCN), also called its Medicare provider number, is 399817.

What is Upmc Hamot's NPI number?

The National Provider Identifier (NPI) on file for Upmc Hamot is 1487647590.

What health system is Upmc Hamot part of?

Upmc Hamot is affiliated with UPMC.

Which insurance plans are in network at Upmc Hamot?

Upmc Hamot lists 28 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.

What price transparency data is available for Upmc Hamot?

250 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.

What is a hospital price transparency MRF?

Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.

What is a chargemaster review?

A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

Compliance MRF

Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
  • CMS template layout, in JSON or CSV
  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
Talk to us about your MRF
Chargemaster analysis

Get your chargemaster right for billing and payer contracts

Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.

What a review covers

CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
  • Charges set below payer allowables caught before lesser-of clauses cut payment
  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
  • Your negotiated rates benchmarked against peer hospitals for the same payers
Talk to us about your chargemaster