Payment, Billing & Financial Assistance Policies
BILLING AND COLLECTION POLICY
Please be aware that each time you receive services from us a separate account is created. It is possible to have several accounts open at the same time. If you provided us with insurance information, your insurance company will be billed as a service to you. Insurance is designed to reimburse the policyholder and is a contract between the policyholder and the insurance company. We will submit benefit claims to your insurance company if all required information and authorization is provided. You are responsible for deductibles, co-insurance, and any items not paid by insurance. You should contact your insurance company to determine your cost-sharing responsibilities, if any.
A claim will be submitted to your insurance based on information you provided during the registration process. This could be as soon as 3 days after your discharge or release from the hospital. You may request a copy of your bill by contacting the number on the front of this statement. Generally, we allow 30 days for insurance to pay their portion. In the event that your insurance company is slow to pay or for some reason disallows the claim, payment of the full account balance is expected from you. You can avoid future billing notices by calling your insurance company to expedite payment. Our collection process will include additional billing notices every 28 days, until the account balance is resolved or placed with a collection agency.
It is important for the hospital and the patient to work together to solve payment issues. If you have any questions please feel free to call our hospital Business Office Customer Service Department at the phone number provided on the front of this notice.
PHYSICIAN BILLING INFORMATION
During the care you received at our facility you may have received services from physicians or other medical providers, such as Anesthesiologists, CRNA's, Radiologists, Emergency Room Physicians, etc. You will receive separate bills from these physicians or medical providers. Should you have any questions concerning their bill, please contact them directly. A list of the physicians and medical providers who bill separately is also enclosed.
PAYMENT POLICY
Payment in full is required at the time of service from all patients who owe co-pays, coinsurance, have not met their deductible, or do not have insurance coverage. Balances after insurance payment are due upon receipt. Please submit your payment along with the top portion of this statement in the enclosed return envelope. You may pay on-line with debit/credit card or electronic check by visiting our website listed on the front of this notice. You may contact the hospital Business Office if you are unable to pay your balance in full. Staff is available to answer any questions as well as discuss our financial assistance program and payment options. Our patient liaison can be reached at
Estimates for upcoming scheduled or future elective services can be provided upon request by the Hospital Patient Access or Scheduling departments.
FINANCIAL ASSISTANCE SUMMARY
Our hospital is committed to treating all patients regardless of their ability to pay and providing financial assistance to persons who have healthcare needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for their medical care based on their individual financial situation under our hospital's Financial Assistance Program. No patient will be denied financial assistance due to his or her race, religion, national origin or any other basis prohibited by law.
Financial relief may be available to patients who receive non-elective care, do not qualify for state or federal assistance, and are unable to pay a substantial portion of their balance, either directly or through a third-party payer source.
We offer a Charity Care Discount under our Financial Assistance Program to patients who qualify under our policy, based on multiples of the U.S. Federal Poverty Guidelines, which will be evaluated using certain financial criteria and supporting documentation to verify income provided by the patient. A patient may apply for the Charity Care Discount by filling out our Financial Assistance Program ("FAP") Application linked below and returning it to the hospital, along with any required documentation, at the time of service or any time after care is provided during the patient's billing cycle. Please be aware we may use your application to identify other available health insurance options you might be eligible for, such as: Medicaid coverage, disability coverage, victims of crime, COBRA, etc. Click here to download a financial assistance application. Click here to download a copy of the U.S. Federal Poverty Guidelines.
Patients who do not qualify for our Charity Care Discount may still be eligible for financial relief under the hospital's Financial Assistance Program. Patients without insurance or any other third-party payer source, who are not eligible for government assistance or our hospital's Charity Care Discount, will receive a discount from the hospital's billed charges, referred to as the "Uninsured Discount." Additionally, a patient may also be eligible for a "Catastrophic Care Discount," in the event the patient's account exceeds a certain percentage of the patient's gross annual income.
We also provide eligibility screening services that can help identify the availability of resources to cover medical services, such as Medicaid.
Please contact the hospital's Customer Service, Patient Access Director or Financial Counselor for more information on the discounts and qualification requirements offered under the hospital's Financial Assistance Program or to learn about any other payment plans that may be available to you at the hospital. Click here to download a copy of our Financial Assistance Policy.
Accepted In-Network Plans
- COMMERCIAL MANAGED CARE
- MEDICAID MANAGED CARE
- MEDICARE MANAGED CARE
Download the Financial Assistance Policy
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