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Understanding Balances Due For Services, Billing & Collection Procedures and Your Payment Options


Registration Process

The registration process takes about 7 minutes for returning patients and about 15 minutes for new patients. Therefore, please make arrangements to arrive prior to your scheduled service(s). Minors must be accompanied by a parent or legal guardian. In order to ensure that we have the most current information for you and your insurance carrier, you will need to bring the following items with you to the Registration Office: Physician Order, Insurance Card, and Driver's License.

It is the patient's obligation to provide a correct mailing address and valid phone number at the time of service or upon moving. If an account does not have a valid address, the determination for reasonable effort to contact the patient in relation to balances due on behalf of Pinckneyville Community Hospital shall be considered to have been made.

Billing & Collection Procedures

Healthcare services are often unexpected expenditures. With current national healthcare changes, complex insurance plans and growing deductibles, Pinckneyville Community Hospital is here to assist patients with gaining a better understanding of the amount patients will be expected to pay for services rendered. Please visit our website at www.pvillehosp.org under Patients & Visitors, Hospital Charges for additional information related to hospital charges, price estimates and understanding hospital pricing.

Pinckneyville Community Hospital works with patients on or before the date of scheduled services to begin discussing balances that patients will be responsible for. This will include discussions of payment expectations at the time of service. A minimum payment will be expected to be paid on the date of service. For scheduled services, the Hospital will contact the patient's insurance company to obtain current information on co-pays, deductibles and coinsurance balances that insured patients will be expected to pay. If the patient has recently had services at another hospital that have not yet been billed to their insurance (patient has not received an explanation of benefits from the insurance company), the patient will need to bring in payment receipts and/or billing statements to prove deductible and coinsurance balances that differ from that provided to the hospital by the patient's insurance company.

Pinckneyville Community Hospital offers prompt pay discounts for balances paid in full. However, the Hospital is also sensitive to the needs of those who do not have the ability to pay their entire balance in full. Therefore, Hospital staff works with patients to determine potential eligibility for finance need assistance or to establish payment arrangements so as to remove some of the burden associated with receiving medical treatment. The Hospital offers interest free payment arrangements on accounts for up to 12-months. If a patient needs more than 12-months to pay a balance due, there are available options for extended payment terms to fit the patient's financial needs. Major credit cards and debit cards are accepted. Patients may also talk with their bank or a personal lending institution in order to obtain an extended payment term loan.

Once any applicable insurance payments are received, you will receive an initial billing statement showing the balance you owe. You may request a detailed billing statement by contacting the Billing Office. Your insurance carrier may send you requests for additional information. Please respond promptly to any such requests. If you do not respond, your insurance carrier will not process your claim and you may be responsible for the entire balance due.

If accounts are not paid in full, if payment arrangements are not established or if Medical Promissory Note payments are delinquent, your account will be forwarded to a collection agency, attorney or small claims court and any associated costs will be added to your bill. Our collection agencies do report unpaid balances to the Credit Bureau.

Other Health Care Professionals Will Bill You Separately

As a patient, you may receive separate bills for services provided by health care professionals affiliated with Pinckneyville Community Hospital. Some hospital staff members may not be participating providers in the same insurance plans and networks as Pinckneyville Community Hospital. You may have greater financial responsibility for services provided by health care professionals at Pinckneyville Community Hospital who are not under contract with your health care plan. Any questions that you may have about your insurance coverage or benefit levels should be directed to your health care plan and/or certificate of coverage.

Patient Financial Assistance

Illinois Uninsured Patient Discount Act: An uninsured patient who meets certain income requirements may qualify for an uninsured discount. The patient must be an Illinois resident and not covered under any health insurance policy, including high deductible health plan, work comp or accident liability insurance. The patient must have household income at or below 300% of the Federal Poverty Level. The patient must submit a completed application within 60 days from the date of service. If the submitted application is incomplete, the patient has an additional 30 days from the date of request to supply required documentation. If deadlines are not met, the patient forfeits eligibility for the Uninsured Patient Discount but may still qualify under the Hospital's Financial Need Program if household income is below 300% of the Federal Poverty Level. If the patient qualifies for the Uninsured Patient Discount, the patient's bill will be discounted and the maximum amount owed by the patient will be 135% of the hospital's cost for services.

Financial Need Program: Applications are available upon request if you are uninsured and need assistance in paying balances due for Hospital Inpatient and Outpatient services and for Family Medical Center visits. Insured individuals with catastrophic medical and financial situations may also be eligible. Based upon supporting documentation provided and if the patient's household income is below 200% of the Federal Poverty Level, you may be eligible for a full or partial reduction of the balance you owe.

Exclusions:

1. Elective procedures. An elective procedure is a planned, non-emergency procedure that may be either medically required (e.g., cataract surgery), or optional (e.g., mole removal for cosmetic purposes). While an elective procedure may improve the functional quality of life (e.g. cataract surgery) they are technically an "optional" or elective procedure.

2. Non-emergency and non-medically necessary care, which shall include (not all inclusive), Nursing (respite) Care that is solely private pay.

3. Outpatient senior behavioral health services provided at the Hospital's Senior Life Solutions facility.

4. Services received from care providers not employed or contracted by Pinckneyville Community Hospital for which the Hospital or Family Medical Center bills the associated professional fees. Patients are encouraged to contact these providers directly to inquire into any available assistance and to make payment arrangements.

Please contact our Financial Counselor for additional information.

Payment Options

1. Payment methods:

A. Cash, check, MASTERCARD, VISA, DISCOVER, AMERICAN EXPRESS or debit card.
B. Financing through a lending institution of the patient's choice.
C. On-line bill payment via credit card, debit card, or electronic check at www.pvillehosp.org.

2. Prompt Pay Savings: Applicable for payments in full for which the patient is not already receiving discounts under Financial Need or the Illinois Uninsured Patient Discount.

A. Uninsured patients: 20% savings on estimated balances paid in full at time of service or paid in full up to 30-days from initial statement.
B. Insured patients: 10% savings on estimated deductible & coinsurance balances paid in full at time
of service or paid in full after insurance has paid up to 30-days from initial statement.
C. Patients must ask for the savings if paying in person, or indicate on mailed check, "savings applied".
D. Refunds will not be made for savings not taken by patients.

3. Patients with prior timely payment history:

A. Pay 100% of estimated amount due in full prior to service with prompt pay discount, (or)
B. Make minimum required payment of 10% of estimated balance due prior to service, with a $100 minimum, and sign a Patient Estimation/Medical Promissory Note regarding payment of remaining balances.
C. Non-emergency services will be rescheduled pending payment or financial assistance approval.
Applies to both scheduled and non-scheduled, non-emergency outpatient ancillary services. Excludes patients covered by Medicare & Medicaid and emergency, oncology, observation and inpatient services.
D. Pay remaining balance in full within 30-days of initial statement to qualify for prompt pay discounts.
E. Set up a 12-month interest free payment plan: A signed Medical Promissory Note is required.
Payment delinquencies will subject the balance to immediate collection proceedings.

4. Patients with prior unpaid balances in collections:

A. 50% of estimated balance due prior to new services being rendered, with a $100 minimum, and sign a Patient Estimation/Medical Promissory Note regarding payment of remaining balances.
B. Non-emergency services will be rescheduled pending payment or financial assistance approval.
Applies to both scheduled and non-scheduled, non-emergency outpatient ancillary services. Excludes patients covered by Medicare & Medicaid and emergency, oncology, observation and inpatient services.
C. Arrangements made for payment plan on prior balances via signed Medical Promissory Note.

5. Financial Need & Uninsured Discount Act Application:

A. Qualification is based upon the patient/guarantor's household income as compared to federal poverty guidelines.

Office Hours:

Billing & Financial Counselor Office: Monday - Friday 8:00 a.m. - 4:00 p.m. (approximate hours)

Contact Information:

Hospital Office Manager: 357-5924
Medicare Billing: 357-5919
Commercial Insurance: 357-5921 or 5973
Medicaid Billing: 357-5959
Patient Financial Counselor: 357-5906 or pchfinancialassistance@pvillehosp.org
Payment Arrangements: 357-5980

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