Amount Generally Billed Calculation

Sacred Heart Health System calculates two AGB percentages – one for hospital facility charges and one for professional fees – both using the “look-back” method and including Medicare fee-for-service and all private health insurers that pay claims to the Organization, all in accordance with IRS Reg. Sec. 1.501(r)-5(b)(3), 1.501(r)-5(b)(3)(ii)(B) and 1.501(r)-5(b)(3)(iii). The details of those calculations and AGB percentages are described below. The AGB percentages for Sacred Heart Health System, Inc. are as follows:

AGB for hospital facility charges:

  • Sacred Heart Hospital Pensacola  28.1%
  • Sacred Heart Hospital on the Emerald Coast  20.6%
  • Sacred Heart Hospital on the Gulf Coast  29.2%

AGB for physicians’ professional fees:

  • Sacred Heart Medical Group  48%

These AGB percentages are calculated by dividing the sum of the amounts of all of the hospital facility’s claims for emergency and other medically necessary care that have been allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility (separately for facility charges and professional services) by the sum of the associated gross charges for those claims. The only claims that are utilized for purposes of determining the AGB are those that were allowed by a health insurer during the 12 month period prior to the AGB calculation (rather than those claims that relate to care provided during the prior 12 months).

(Updated:  July 1, 2018)


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