Billed charges are the total amount charged directly to the insurance company or the patient if they are self-paying. These charges are created by the codes entered for each patient case and services delivered.
ClaraPrice estimates are calculated using a scientific formula based on the DRG system (diagnosis related groups). This means conditional factors that can change the DRG for each patient’s case get included in the ClaraPrice formula. DRG-based pricing is government approved, as these are generated from Medicare data. Therefore negotiated pricing with insurers do not appear in ClaraPrice estimates, giving patients a big universal estimate of their hospital stay that includes their individual health situation.