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Patient Financial Responsibility
We appreciate you choosing St. Mary's Medical Center. As part of our quality
service
we feel it is important that you are informed of our payment policies.
How much will it cost?
If you would like to obtain a verbal estimate for a procedure you are having,
please
call our St. Mary's/St. Joseph Medical Center Price Quote Line,
816-943-2192 Option #6.
Be prepared to leave your name, telephone number, which hospital, and any
information
you have about the procedure. We will return your call within 24 hours, Monday
thru
Thursday, and if you call after 5 p.m. on Friday or over the weekend, we will
call
by the following Monday.
Factors such as insurance deductible, co-insurance, or co-pays may affect your
out
of pocket responsibility so please check your insurance benefits.
Insurance Patients: Please verify with your insurance company that you have met
your precertification requirements and/or referral requirements prior to
services
being rendered. Please bring referral and/or precertification letter with you.
Timely Filing: Many insurance companies require claims to be filed within pre-defined time frames. To enable our Business Office to file a claim on your behalf in a timely manner, please make sure updated insurance information is provided at the time of service. You will be asked to review your face sheet at time of registration. Please take this opportunity to carefully review all of your personal information your (patient) name, address, guarantor name and address as well as make sure insurance information is updated and correct. Failure to provide insurance information in a timely manner could result in the bill becoming your responsibility.
Reminder to Insurance Patients: Because your insurance company expects prompt
remittance
of your premium, you have a right to expect their prompt payment of your
claims.
Please contact them to ensure payment within 30 days from the billing date
(excluding
Medicare), and for second insurance, within 20 days from the date the primary
insurance
pays. Your cooperation will:
- assist the hospital in containing your health care costs
-
prevent follow-up phone calls to your home or office.
Insurance Information
If you were unable to provide complete billing information at the time of your
visit,
please phone the information to the following numbers: WITHIN 48 HOURS:
655-5503, AFTER 48 HOURS: 655-5415
Be prepared to give patient name, insured name, insurance name, mailing
address,
policy numbers, group numbers for both primary and secondary insurance plans
and
pre-cert number.
Auto Accident: Written authorization is requested in order to bill for
auto
policy benefits. Without this, the medical center will look to the patient for
payment
in full.
Workers' Compensation: Phone verification and/or written approval is
required
to bill an employer for any medical claims.
Parents of Minor Children: Insurance regulations now require the primary
insured to be determined by parent with the first birth date of the calendar
year.
Minor Children/Guarantor Responsibility: The parent signing the consent
for
treatment will be the billing guarantor unless written authorization states
otherwise.
HMO/PPO Insurance Coverage Authorizations: Most health maintenance and
preferred
provider organizations REQUIRE you or your doctor to contact them for treatment
authorization. Should they defer your benefits from coverage at St. Mary's
Medical
Center, WE DO NOT DENY YOU CARE; it means you will be financially responsible
for
the bill and payment will be necessary at the time of service. Call your
insurance
agent for information regarding your plan.
Billing from separate offices
Cardiovascular Procedures: The Cardiologists who practice
in the medical center are
required by law to interpret non-invasive cardiovascular procedures and send a
report
to the referring physician. Therefore, the Cardiologist will submit a bill to
Physicians
Business Network (PBN), P.O. Box 871953, Kansas City, MO 64187-1953, for any
professional
fees associated with non-invasive procedures. You will receive a statement from
PBN. The medical center will show a charge for use of the treatment room and
other
services provided.
Some Cardiovascular Procedures that are billed by PBN:
- EKG - Electrocardiogram - Routine $33
- Cardiovascular Stress Test -Routine $80
- ECG Monitor -Routine $162
- Echocardiography - Routine $231
-
Doppler Color Flow Mapping
X-ray Charges: The Radiologists (X-ray specialists) who practice in the
medical
center are required by law to read all x-ray examinations and send a report to
the
referring physician. Therefore, the Radiologist (Carondelet Radiology, div. of
Alliance
Radiology, PO Box 804451, Kansas City, MO 64180, telephone 913-432-3909) will
submit
a bill to you for their services. The medical center will show a charge for the
use
of the x-ray room and other services provided.
Emergency Department Physicians: The Emergency Department physicians at
St.
Mary's Medical Center (Medical Billing Solutions, P.O. Box 414965, Kansas City, MO 64141) will submit a separate bill to
you
for their services in diagnosing and treatment of a patient's illness. The
medical
center will bill for the use of the Emergency Room and services.
Anesthesia Services: Anesthesia services are provided by St. Mary's
Anesthesia
Services and can be reached at (816) 389-4130.
If you have received a separate bill from a physician office and would like to
contact
that office, here are some helpful numbers:
Alliance Radiology
P O BOX 804451
Kansas City, MO 64180
913-234-1600
Anesthesia Services of Blue Springs
P.O. Box 8335
Prairie Village, KS 66208-8335
816-389-4130
Clinical Cardiovascular Associates
P.O. Box 8650
KCMO 64114
913-381-7117
Medical Billing Solutions (MBS - Billing for St. Mary's Emergency Department Physicians)
PO Box 414965
Kansas City, MO 64141-0965
913-469-1411
Neurology (EEG)
6420 Prospect
Suite T4119
KCMO 64132
816-756-2651
Physicians Reference Laboratory
PO Box 7210
Shawnee Mission, KS 66207
866-674-0395
Pierre W. Keitges, M.D.
P.O. Box 875865
KCMO 64187
866-674-0395
Pulmonary Medicine
4911 S. Arrowhead Drive, #201
Independence, MO 64055
816-478-8113
Frequently Asked Questions
Why Doesn't My Insurance Pay For This? Every policy is different and
many
have limits on what they will cover. You may be required to pay more for a
service
if you have not yet met your annual deductible, or if the service is not
covered
by your policy at 100%. Medicare and Medicaid also have limits on what they
will
pay for hospital and physician services.
What is a Co-Pay? Most HMOs (Health Maintenance Organizations) and some
other
forms of insurance require patients to pay a small payment each time they visit
a doctor or go to the hospital. This payment can be as little as $15 or may be
as
high as $50 or more, depending on your specific policy. This co-pay is required
each time you visit the doctor or hospital.
What is a Deductible?
Some insurance policies, especially PPO's (Preferred Provider Organizations)
and
so-called "traditional" policies, require you and/or your family to pay a
minimum
amount per year toward your healthcare expenses. This deductible could be as
little
as $250 per year, or as much as $1,000 or more. You will be required to pay for
all of your healthcare expenses until you have met this deductible amount.
After
you reach the deductible, your insurance company will then pay for most, or
sometimes
all, of your bill. You only have to meet your deductible once each year.
Be aware that your policy may require both a co-payment and a deductible. In
this
case, you will be required to continue to pay a co-pay amount even after you
have
met your deductible.
What is Co-Insurance?
In some instances, an insurance plan may require you to meet your annual
deductible
as well as to pay Co-insurance even after the deductible is met. Co-insurance
is
usually based on a percentage of either the provider's actual charge or
provider's
allowed charges. Some insurance plans have a co-insurance that is as little as
10%,
while others can be 50% or more.
What Things Are Covered By Insurance?
Typically, most insurance policies will cover hospital and physician charges
when
you are sick, including lab tests, x-rays and other related tests. Many
policies
do not cover other services such as medicines, home health, nursing home stays,
wheelchairs, non-emergent ER visits, etc. Please check your policy for details
or
call your insurance company if you have questions.
Will I receive a bill from only the hospital?
No. The hospital will bill you or your insurance for only the technical, or
hospital,
component of your visit. All physicians (including your ER Physician,
Radiologist,
Pathologist, Cardiologist, Anesthesiologist, Neurologist, etc ) will bill
separately
for their professional services. If insurance information is provided at time
of
service, the companies listed above will bill your insurance on your behalf.
What Things Will I Be Responsible For Paying?
You will be responsible for paying any amount not covered by your insurance
policy.
This may include a co-payment, some or all of your deductible, co-insurance,
and
expenses that are not medically necessary or not covered by your insurance
policy.
What if I Have No Insurance Coverage?
Please notify our Financial Representatives and we will work with you to
develop
a reasonable payment plan. In some cases, you may be eligible for charity care
coverage.
What is an Insurance Discount Card?
There are companies now selling "discount cards" for hospital and doctor
services
to patients. These cards often cost as much as $60 per month or more ($720 per
year)
and promise to provide patients with discounts on their doctor and hospital
bills.
Unfortunately, many of those discounts are not offered by your local doctor or
hospital;
often, they are discounts provided by large hospitals or physician groups in
other
cities, or by chains of health-related businesses (such as pharmacies, etc.).
Before
you decide to purchase a healthcare discount card, it is best to determine if
it
offers any benefit to you here in our area. Be sure to ask if your doctor or
hospital
will honor the card and offer you a discount.
What if I Can't Afford To Pay All of My Bill Right Now?
If you are unable to pay your bill in full upon receipt, you must notify St.
Mary's
Medical Center's Financial Representatives so that a reasonable payment plan
may
be worked out. Most balances must be satisfied within 6 months of the date or
service,
or date that insurance paid.
Who Can Receive Charity Care?
Most patients are eligible for charity care at St. Mary's Medical Center if
their
income falls below 200% of the federal poverty level, based on the size of
their
family. Your financial counselor can help determine if you are eligible for
charity
care at St. Mary's Medical Center.
Will I Get Calls From Bill Collectors?
If you pay your bill on time and according to the payment plan you work out
with
St. Mary's Medical Center, your account will not be referred to a Collection
Agency.
It is very important that you contact the Business Office immediately if you
are
unable to pay any portion of your bill. In most cases, St. Mary's Medical
Center's
financial counselor will work with you to make other arrangements for you to
pay
what you owe. However, if you miss one or more payments and do not contact us,
we
may refer your bill to a Collection Agency.
How Do I Reach My Financial Counselor?
Financial Representatives are available to answer your questions, Monday
through
Friday, 7:00am-6:00pm CST.
Call Us
St. Mary's Medical Center Business Office
816-655-5415
Fax: 816-655-5414
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