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Billing & Financial Assistance

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No-one will be denied access to services at MMC due to their inability to pay. There is a discounted/sliding fee schedule available.

Each time a patient receives services at Memorial Medical Center, a separate account is created. If the patient is receiving monthly ongoing services, a monthly account is created. It is possible to have several accounts open at the same time, for which separate statements will be received. Statements may reflect accounts billed to health plans that are not yet resolved, or balances that you may owe.

Memorial Medical Center accepts cash, check, money order, or credit card (MasterCard, Visa, Discover and AMEX). We also accept MA, Medicaid and CHIP. MMC accepts patients regardless of their inability to pay. We provide insurance billing and follow-up services for patients who assign third party benefits to the hospital. After the insurance carrier has processed the claim, or if the patient does not have insurance, the remaining balance becomes classified as “self pay.” To assist in financing this balance, the following options are available:

  • Balance of account to be paid in full in thirty (30) days.
  • Interest Free Financing – Special arrangements can be made through Patient Financial Services. Generally, balances are required to be paid within 24 months or a minimum of $25 per month, whichever is greater.
  • Financial Assistance is designed to help patients who are financially unable to pay for health care services. Program eligibility is determined by measuring family income against the current poverty guidelines and established by the Department of Health and Human Services. Application to the program is a prerequisite and is made available to the patient at any time.
  • All patients will be given the opportunity to apply for financial assistance at the time of admission and again if they have not applied when the billing is mailed.

Below you will find information regarding your rights against surprise medical billing (sometimes called “balance billing or no surprises billing”). Also, learn how to receive a “Good Faith Estimate” explaining how much your medical care will cost.

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Billing and Collection Policy

No-one will be denied access to services at MMC due to their inability to pay. There is a discounted/sliding fee schedule available.

The Billing and Collection policy of Memorial Medical Center and its employed medical partners (collectively MMC), together with the Financial Assistance Policy establishes that actions may be taken in the event of nonpayment for medical care provided by MMC, including but not limited to extraordinary collection actions. The guiding principles behind this policy are to treat all patients and Individual(s) Responsible equally with dignity and respect and to ensure appropriate billing and collection procedures are uniformly followed and to ensure that reasonable efforts are made to determine whether the Individual(s) Responsible for payment of all or a portion of a patient account is eligible for assistance under the Financial Assistance Policy.

The full MMC Billing and Collection policy is available here.

No Surprises Billing

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency Services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have these protections:

  • You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
  • Generally, your health plan must:
  1. Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
  2. Cover emergency services by out-of-network providers.
  3. Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  4. Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, contact Memorial Medical Center Patient Financial Services at 715-685-5500. The federal phone number for information and complaints is: 1-800-985-3059.

Visit http://www.cms.gov/nosurprises/consumers for more information about your rights under federal law.

OMB Control Number: 0938-1401
Expiration Date: 03/31/2022

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit http://www.cms.gov/nosurprises or call Memorial Medical Center Patient Financial Services at 715-685-5500.

OMB Control Number: 0938-1401
Expiration Date: 03/31/2022

 

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