The rising cost of healthcare, particularly in outpatient departments (OPDs), poses significant challenges for patients who often shoulder expenses out of pocket. This study explored the cost-consciousness of OPD patients in a Level I hospital in San Juan, Batangas, and examined their awareness of medical bills. Utilizing a mixed-methods approach, the quantitative phase employed a descriptive cross-sectional design with 150 OPD patients, while the qualitative phase applied a phenomenological design through in-depth interviews with 22 participants. Findings revealed that most patients were unaware of the actual costs of their medical care, with awareness highest for medications but lowest for procedures and medical supplies. Lack of cost awareness was linked to delayed treatments, poor adherence, emotional distress, and financial strain. The study concludes that cost unawareness significantly affects patient outcomes and decision-making. It underscores the urgent need for clear price disclosure, improved billing communication, and patient education. Policy recommendations include institutionalizing transparent pricing, streamlining financial aid processes, integrating financial counseling in OPD services, and leveraging telemedicine to reduce indirect costs. A research simulacrum was also proposed to guide policy modeling and implementation. Ultimately, this study highlights the vital role of financial transparency in advancing healthcare equity and improving access to essential services.