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MAKING THE MOST OF YOUR HOSPITAL STAY A Primer for Patients and
their Families
Providing Admissions and
Billing Services for To our Patients and Families: It is
not a laughing matter when we hear stories that the most painful part of a
hospital visit was the paperwork and billing that accompanied it. Patient
Business and Financial Services (PBFS), the arm of Halifax Community Health
System dedicated to providing registration services and responsible for
accurate billing and responsible collections, is anxious that the process be
clear, and that you encounter no surprises as a result of hospitalization. This
booklet is the work product of representatives of our PBFS Team who are in
daily contact with patients and the people who make our system work. They have done an outstanding job of
capturing the questions and comments we most often hear and setting forth our
policies in clear language. The Team
members responsible are Glen Stockhammer and Susan Campbell, who chaired the
effort, and Judy Bridgman, Jimmese Ponder, Barbara Zdanis, Melissa Lanseer,
Cathy Huss, Donna Nigh and Susan Barbaro.
We appreciate their work and know they would welcome your comments to
improve future editions. It
bears repeating that PBFS is here to help.
We can only do so when we know your needs, so please do not hesitate to
call on us. Arvin
Lewis Vice
President Table of Contents Why All the Paperwork For My Hospital Visit? Our Policies for Your Payment(s) Additional Ways Payments May be Arranged Why
all the Bills from Other Providers? How This Booklet May Help You {Back to Table of Contents} Having to go to the hospital, whether for an outpatient procedure or for care that will require an inpatient stay, can be a scary thing. The registration and the paper work involved can seem overly complicated. On the next few pages we will try to explain why we take the steps needed to ensure Halifax Medical Center (HMC) is paid for the services we provide, which is absolutely necessary if we are to keep the cost of healthcare down for all healthcare consumers. You will also find in Question and Answer format, the most frequently asked question(s) from scheduling, registration, medical records, and the business office. Halifax Community Health System (HCHS) is the operating
company for The most important message we have for you is that we are here to help you before, during and after your visit in one of our facilities. A call to customer service will connect you to one of our team members ready to help answer your questions, and willing to get you any additional information you may need. We want you to know that from your doctor’s office to our business office, we care about your well-being. Why All the Paperwork For My Hospital Visit? {Back to Table of Contents}
Your doctor tells you a hospital visit is necessary. Sometimes before the date of your procedure you may be asked for information about yourself and your insurance coverage. If you do not have insurance, in some situations where elective procedures or services are ordered, but not considered medically urgent or emergent by your physician and/or our case management staff, HMC reserves the right to postpone or re-schedule any procedure or service until acceptable financial arrangements have been made to pay for the service(s). When you arrive on the scheduled date for your procedure, you will discover that the reason you have been asked to come early is that you will be faced with an array of forms, information flyers and consent documentation, along with having to show a picture ID and copy of your insurance cards. All of this information is needed to insure your privacy is fully protected, that we eliminate any possibility of identity theft, and that HMC is paid for the services rendered. You will be asked to review and provide us with direction as to how you want your privacy as a patient protected. For example, you can specify as to whether you want it known that you are a patient in our facility. You will be asked if you have an Advance Directive, which sets forth your wishes for the level of care you wish to receive in the event that you are unable to make those decisions for yourself. This important document, which we recommend, allows you to designate someone to act in your behalf. Advance Directive forms are available for you at any point of registration in the hospital. About
Insurance {Back to Table of Contents} From time to time you see newspaper stories that an insurance company has entered into a contract, or no longer has a contract with Halifax Medical Center (HMC). Before you come to the hospital for elective (non-emergency) services, we recommend that you contact your insurance company regarding how they will pay the claim and if our hospital is a participating provider, therefore avoiding “out of network” higher deductibles, co-pays and co-insurance amounts. Keep in mind that it is your responsibility to know your insurance contract and which providers participate with your insurance plan. As a courtesy to our patients, we will file a medical claim (bill) to any health insurance company for services rendered at our facilities. We can only do so when the patient or guarantor has provided complete and accurate insurance information to us when arrangements for your care are made, or at the time services are rendered, or immediately thereafter. We must have your insurance information in a timely manner in order for the proper authorizations, pre-certifications, referrals required by your insurance company are obtained, and any other notification that the company requires in order to pay for your treatment, tests or hospital stay. Failure to meet these obligations may result in the patient or guarantor being responsible for the services rendered as a result of the insurance company not remitting payment. PBFS will make a reasonable attempt to collect the debt incurred from the insurance carrier, if for any reason your insurance company denies your claim or neglects to pay the bill, you, as the patient or guarantor, will ultimately be responsible for the charges incurred. With the exception of those payers HMC has entered into a contractual relationship with, HMC is not bound to accept the reimbursement that an insurance company may pay or allow for the services rendered as payment in full. For example, some insurance companies use a payment methodology known as “UCR” (Usual & Customary Reimbursement) or otherwise known as an “Allowable”. Both of these payment (reimbursement) methodologies are determined by your insurance company and are not a mutually or contractually agreed upon amount of reimbursement between HCHS and the insurance carrier. This means that any difference between our total charges and the “UCR” or “Allowed” amount is the responsibility of the patient or guarantor. Please check your insurance contract to see if your insurance carrier or coverage reimburses by either of these payment methodologies to prevent any unforeseen or non-covered medical costs. Should you have any questions or concerns regarding what insurance carriers or networks HMC has entered into a contractual relationship with, please call our customer service department. For your convenience, you may also contact us via E-mail at PBFScustomerservice Our Policies for Your Payment(s) {Back to Table of Contents} We accept the following form of payment at Halifax Medical Center (HMC) · Cash · Personal, Travelers, or Cashier checks · Debit Cards (An ATM machine is located in the admission office of HMC) · Credit Cards (Master Card, Visa and American Express) · Discover Card is only accepted at HMC It is the policy of HMC to request that all estimated patient portions due, and all co-pays, co-insurance and deductibles, be paid in full prior to services, upon completion of services or at the time of discharge. When you
receive a statement with a balance due, you may notice the return address is in
Payment Arrangements HMC, with the cooperation of the patient or guarantor, may agree to enter into a payment arrangement contract based on the following:
In order to enter into a payment arrangement HMC requires you, or someone guaranteeing payment, to sign a Promissory Note and a Truth in Lending Disclosure document when the repayment period is to be more than four (4) months. The key provisions of the documents are: · The documents are a binding agreement to extend credit to the person signing the documents, and set forth the expected repayment, as would any other lending institution. · You are not charged interest on the balance due or credit extended to you. · Missing two (2) consecutive monthly payments will constitute a default of your payment plan. · Failure to communicate reasons for non-payment could result in defaulting on your payment plan. · A payment arrangement with us does not affect your credit or go on any credit report unless you default in your payments. All payment arrangements are monitored by our collection agencies, as they are responsible for sending you statements and monitoring the accounts for payments. If your account defaults, the account immediately moves from a payment monitoring status to an active collection status which will result in further collection activity on your account and may affect your credit. If you are making payments on your account, but have not entered into a formal payment arrangement (Promissory Note) with HMC, your account will follow the normal collection process, including but not limited to placement with a collection agency and in some cases legal action. Additional Ways Payments May be Arranged {Back to Table of Contents} Voluntary Mortgage Liens We understand that medical bills can rapidly mount up and meeting them can become a difficult challenge. The Voluntary Mortgage Lien (VML) is an option given to you so that you may meet your responsibilities. By using the VML, payment will be secured to the hospital by using your personal property, which offers sufficient equity value. The property must be worth enough to insure that your account can be paid when the property is sold. You may want to consider the VML:
Key provisions of a Voluntary Mortgage include the following:
Auto Insurance Benefit Liens The auto insurance benefit lien process was created by the
Florida Legislature specifically to provide payment to providers for care
resulting from an automobile or motorcycle accident prior to attorneys or others
receiving the insurance proceeds. HMC
reserves the right to file an auto insurance benefit lien against any insurance
benefits pertinent to the accident, including but not limited to your personal
auto carrier coverage as well as any third party carrier coverage with respect
to the accident. It does not increase the cost of your care, and, in fact,
helps hold costs down through effective collections. This lien in no way affects your personal
credit rating and does not attach to personal or real property. You may receive notice that such a lien has
been filed without prior notification from us. Financial Assistance Program HMC has different financial assistance programs, which may be available to you upon application and financial review. Please contact our financial counselors to inquire into your potential eligibility for one of these programs and/or possible referral to other programs outside of HMC for which you may be eligible. Why all the Bills from Other Providers? {Back to Table of Contents} If it isn’t enough trying to figure out a hospital bill, many patients find themselves getting bills and statements from a variety of other providers. Physicians and other healthcare professionals that you may or may not have direct contact with but provide a service to you, or which are involved in some aspect of your healthcare, will also bill you for their services. For example, if you come to the hospital to have an X-Ray performed, the hospital will bill for the actual X-Ray itself while the radiologist who reads the X-Ray (interprets the findings) will also bill for his or her services. While you may never personally see the radiologist, his or her services are a necessary part of the test to accurately diagnose your condition. Because these other healthcare providers are independent contractors and not employees of the hospital, the possibility exists that these providers may not be participating with your insurance plan (while the hospital may participate), which could cause you some additional or unforeseen expense as a result of this situation. We do not have the right to dictate to these providers which insurance plans they should enter into contracts with. You should be aware that physician and other independent contractors may have separate collection policies, procedures, guidelines and / or re-payment terms, than that of the hospital. Below is a list that includes, but is not limited to, some of the other providers you may also receive bills from:
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