Nobody wants to go to the hospital. Finding yourself in one means you’re either sick or injured, or visiting someone who’s sick or injured. There are more than 34 million hospital admissions every year, and those admissions are expensive: The average daily cost is more than $2,800. Considering the average hospital stay is 4.5 days—totaling nearly $13,000—it’s important that you understand every aspect of the care you’re paying for.The doctors, nurses, and other staff at any hospital undoubtedly want to give you the best care possible—that’s why they chose this profession. But hospitals are more than places of healing—they’re large, sprawling businesses. And like any other large, sprawling business, communication isn’t always perfect, and misunderstandings and miscommunications can result in higher bills and unnecessary costs.The "necessity" of pre-paymentsIncreasingly, when you show up to the hospital for a scheduled surgery or procedure, you’ll be asked to pre-pay some or all of the cost. This often comes with a side order of pressure and intimidation—you might be brought into a room with a hospital staffer, who will go through the costs and ask how much you’d like to pay in advance. The implication is that you have to pay something if you want to receive care—but you almost certainly don’t have to pre-pay anything. The hospital may be happy to let you think you do. But it’s a bad idea for one simple reason: Your final bill may be much lower than the estimate, and getting your money back is never easy.Unnecessary treatmentsDifferent hospital systems have different payment models for doctors, with most combining a base salary with various incentives. The incentive model may sometimes push doctors to perform procedures, tests, or even surgeries that aren’t entirely necessary, but they are usually presented to you as standard stuff that simply has to be done. Even other payment models that adjust compensation based on the time, the skill required, and the resources consumed during a procedure can prompt doctors to do unnecessary stuff in order to boost their pay.Similarly, doctors are often happy to schedule specialists to consult, especially if you have concerns or questions—which is fine, unless those specialists now show up at your bedside every day you’re in the hospital, unnecessarily padding out your bill. It’s never a bad idea to ask your doctor whether something is necessary, or if there are cheaper alternatives worth exploring. And if a specialist pops in just to say hello and ask how you’re doing, question the need for continued visits.Admission vs. observation You might assume that if you stay overnight in the hospital, you have been admitted to a hospital. But “admission” is a specific scenario meaning you’re in the hospital under the care of a doctor. You might be in the hospital under “observation,” meaning you’re considered an outpatient even though you’re in the hospital. Hospital staff may not specify your status, and the difference can have a huge impact on your insurance coverage, so it’s essential that you know for sure.MedicinesHospitals often make a fuss over medications brought from home. Their concern is legitimate: They need to know every medicine you’re taking, even supposedly harmless stuff like over-the-counter painkillers, so they can avoid dangerous interactions and other complications. You might assume that you can only get those medications from the hospital pharmacy, usually at an enormous markup—and when we say enormous, we mean $500 for a single tablet of Tylenol—but you might be wrong about that. You can often bring your own medicines, but you need to consult with your doctor and get them to allow it, and the hospital pharmacy may request to examine your stash to ensure everything is correct.Urgent care vs. hospital outpatient departmentThe emergence of urgent care centers offers an alternative to hospitals and emergency rooms. Urgent care centers are generally less expensive and less crowded, so they can be a solid alternative to a hospital if you’re not dealing with an emergency or serious condition and you’re looking to save a little time and money.Unless, that is, the urgent care is actually a hospital outpatient department (HOPD). HOPDs often resemble urgent care centers, but they are technically part of the hospital that administers them, and thus, they will charge the hospital rate for everything. It can be easy to stroll into a storefront assuming you’re in an urgent care only to realize you’ve been charged hospital rates for services when you get the bill.Price listsHospitals are now required to post clear price lists for services and procedures, but these lists are often outright fictions. Patients sometimes discover that the prices on their hospital bill don’t match the posted list, or that many of the charges aren’t included in the public listing at all. Reviewing the price list before you go into the hospital for a procedure is a great idea so you can estimate your costs. But you have to review that list again after you get the bill—never assume they’re going to match.