ABOUT YOUR BILL

Jackson County Memorial Hospital is committed to providing quality healthcare and services to all patients. This web page is meant to assist you with any questions you might have about JCMH’s accounting and billing systems.

As a courtesy to patients and their families, JCMH’s Patient Accounting Office will submit hospital claims to any insurance company on behalf of the patient. To speed up the claims process, it is important that complete and accurate insurance information be given when the patient is admitted to or registered at JCMH.

You may receive monthly statements while your claim is being processed depending on the arrangement JCMH has made with your insurance company. We appreciate any assistance you can give in helping your insurance company during the claims process. An itemized bill will be sent to you upon request.

PATIENT RESPONSIBILITY
More and more insurance companies are requiring authorization or pre-certification before patients receive any hospital services. Usually, the admitting physician or the policy holder can get the authorization needed for hospitalization. If your insurance company requires this, please tell your physician or call your insurance company. If authorization or pre-certification is not received and is considered necessary by your insurance company, they may deny your claim in part, or in full. Third-party coverage information provided by the patient will be verified and pre-certification obtained when needed. Where there is no third-party coverage, the hospital reserves the right to require a deposit equal to 45% of the estimated billed charges of providing services for the particular illness or operation.

Financial Counselors will verify benefits and, if possible, determine whether or not deductibles have been met for Inpatients, Same Day Surgery, and Outpatient services with large dollar procedures. Prior to (or at) the time services are provided, co-payments and deductibles will be collected. If the patient is unable to pay the estimated due, satisfactory payment must be made. No deposit will be required for Medicare, Medicaid, or Tricare patients.

PAYMENT RESPONSIBILITY
An expected insurance payment to JCMH does not replace the patient’s obligation to pay any outstanding balance. JCMH reserves the right to expect payment directly from the patient or the responsible party in certain situations or if insurance payment is particularly slow.

MEDICARE
JCMH is a certified Medicare provider and will send your bill directly to Medicare for payment. If you have insurance secondary to Medicare, the Patient Accounting Office will submit the supplemental insurance claim. This supplemental claim can only be completed after JCMH has received the Medicare payment, and can only be submitted if all additional insurance information has been provided.

While Medicare must be allowed as much time as needed to process a claim, supplemental insurances will have up to 30 days from billing before the outstanding balance is determined to be the patient’s responsibility.

MEDICAID
Medicaid billings are also submitted on behalf of the patient. If it is determined the patient is not eligible or has not qualified for Medicaid, the patient will be billed for any services received while at JCMH.

WORKER’S COMPENSATION
Work-related injuries will be treated as a normal insurance claim. The employer or claims adjuster will confirm benefits within 48 hours of admission to the hospital.

It is the patient’s responsibility to provide JCMH with all of the appropriate information.

If the claim is disputed, JCMH will bill the patient’s health insurance company in lieu of the worker’s compensation claim. If worker’s compensation is denied and there is no insurance available, the patient will be responsible for the outstanding balance.

INSURANCE
Patient Accounting will bill up to two insurance companies if insurance information and assignment of benefits is given when being admitted to JCMH. Inpatient benefits will be confirmed within 24 hours of admission or on the next working day in the case of weekends or holidays. Any balance not paid within 30 days of billing will become the patient’s responsibility.

HMOS/PPOS
If JCMH has a contract with your insurance company, the bill will be submitted according to contractual obligations. Any coinsurances, deductibles, or non-covered services are the patient’s responsibility and are payable within 30 days of billing.

ACCIDENT AND INJURIES
If you receive treatment as a result of a vehicle accident or public injury, JCMH will hold you personally responsible for your hospital bill. Liens may be filed against insurances or with your attorney. Since such cases may require many months to resolve, JCMH will not wait for final decisions. Payment arrangements should be made on these accounts to prevent them from becoming past due.

WHEN A PATIENT OWES A BALANCE
JCMH expects that patients and/or their families will make a good faith effort to pay any balance due to the hospital. The Patient Accounting Department will work with you to establish a reasonable method of settlement.

1. An account is considered delinquent or past due when:
2. No payment arrangements have been made within 30 days of final insurance payment (or final billing for self-pay accounts).
3. There is no response to our mailings or telephone calls.
4. A required Financial Assistance Application form is not completed.
5. Established hospital financing arrangements are not met.

If you dispute a balance, the situation will be reviewed before further collection efforts are pursued. In cases where all reasonable efforts to collect a balance have been made, the account will be referred to a state-licensed agency for follow-up and collections, or to an attorney for legal action. The cost to collect a suit on an account will be added to the original balance owed.

JCMH has personnel who can assist you in establishing financial arrangements while the patient is in the hospital.

JCMH has established the following guidelines for payment of any balance:

Interest will be charged to all balances that are not paid in full within 60 days of the first bill. The interest will be charged at a rate of 10% APR.

Long-term payment arrangements can be requested by completing a Financial Assistance Application. If unable to qualify for outside assistance, a payment schedule will be made measuring the established payment against the patient’s spendable income (available income after reasonable monthly obligations.)

JCMH honors Visa, MasterCard or Discover card for the payment of any account. Payments are accepted over the telephone, in person, or by mail.

If you have any questions or concerns about any bill you have received from Jackson County Memorial Hospital, please call the following number:

Patient Accounting
580-379-5050