Request a Patient Estimate

Complete the Estimate Request Form below to receive a personalized cost estimate within two business days.

This good faith estimate is based on the most current coverage and benefit information provided by your insurance company (if you have insurance coverage), and the typical care experience for patients receiving similar services from your physician. We would like to caution you that this is not a guarantee of the final amount due. Hospital care is specifically tailored to the needs of each patient. Therefore, the final amount owed may vary based on circumstances involved in your actual services. Such circumstances may include:

  • The length of time spent in surgery or recovery
  • Specific equipment, supplies and medications required
  • Additional tests required by your physician
  • Any special care, unexpected conditions or complications
  • A change in your insurance benefits

Please note that the good faith estimate provided by OVMC-EORH covers hospital services only; it does not include professional fees for services provided by independent practitioners, such as your primary care physician, surgeon, radiologist, pathologist, anesthesiologist, emergency room physician, or other specialist. These providers bill separately from the hospital, and you may contact them directly for pricing information. For your convenience, we have included contact information for the most common independent practitioners at OVMC-EORH.


  • Request Patient Estimate

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    By submitting this form, you give OVMC-EORH permission to contact your insurance company to confirm eligibility and benefit information.