Schedule 1: Amounts Generally Billed

Amounts Generally Billed

If you receive assistance under the CoxHealth Financial Assistance Policy (FAP), the CoxHealth hospital and clinics may not charge you more than the amounts generally billed (AGB) to individuals who have insurance covering the same services. A patient eligible for Financial Assistance is considered to be “charged” only the amount he or she is personally responsible for paying, after all discounts (including discounts available under the FAP) and insurance payments have been applied.

CoxHealth determines AGB by multiplying the hospital’s gross charges for that care by one or more percentages of gross charges, called “AGB percentage.” The AGB percentage is calculated annually by dividing the full amount of all of the hospital’s claims that have been allowed by health insurers during the prior 12-month period by the sum of the associated gross charges for those claims. For these purposes, the full amount allowed by a health insurer includes both the amount to be reimbursed by the insurer and the amount (if any) the individual is personally responsible for paying in the form of co-payments, co-insurance or deductibles. The AGB calculation is performed annually for each hospital and the clinics.

Once eligibility for Financial Assistance is approved, the hospital will apply the applicable Financial Assistance discount described in the Financial Assistance Income and Discount Table. Any balance due by you will be reviewed to ensure it is less than the AGB percentage. If the balance due is more than the AGB allowable amount, an additional discount will be applied to the balance to reduce it to the AGB percentage.

Below is the AGB percentage for the clinics and each CoxHealth hospital.

If you have questions regarding the AGB calculation, please call:

417-269-6765

financialassistanceapplications@coxhealth.com