Billing & Financial Assistance

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Billing & Financial Assistance 2017-09-20T15:58:18+00:00
Billing – Clinic
Financial Aid
MRH Financial Aid
Financial Counseling

Billing Services

Memorial Regional Health is a leader in providing information to our patients and consumers. We realize that it is important for you to make informed decisions regarding your healthcare and we are committed to providing tools necessary to help you understand your physician and hospital charges. The following information is being provided to you in an effort to help you understand provider-based billing.

Certain Memorial Regional Health service locations qualify as “provider-based” in accordance with criteria established by the Center for Medicare and Medicaid Services (CMS), including our Medical Clinics since January 2017. Clinics that are within a 35 miles radius of The Memorial Hospital (the “Hospital”) are eligible to be provider-based if such clinics are operated, monitored and supervised as a hospital outpatient department, and integrate their services such that clinic patients have full access to the services offered by the hospital. Our provider-based clinics in the Memorial Regional Health region are sufficiently integrated with The Memorial Hospital so as to be considered hospital outpatient departments. These provider-based facilities are therefore permitted to generate separate hospital charges, called “facility charges,” to help cover expenses incurred by the Hospital in operating such facilities. Expenses incurred by the Hospital include but are not limited to the salaries of non-physician support staff, equipment and supplies, expenses associated with the operation/maintenance of the building(s), and the costs of maintaining a fully-integrated medical record that allows Memorial Regional Health providers to see a complete history of all inpatient and outpatient services provided to you throughout Memorial Regional Health.

Based on these circumstances, when you receive care at one of the provider-based facilities listed below, you will receive two (2) charges: (1) a professional charge for the services provided to you by the physician or mid-level provider who rendered your care, and (2) a facility charge for the expenses incurred by the Hospital in operating the facility. These charges are equal to the amount that would have been billed as a single charge prior to the conversion to a provider-based clinic.

Many insurance carriers apply the facility charge toward the patient’s hospital deductible. This may result in higher out of pocket expenses for patients depending on their individual coverage and benefits.

To print this information, click here.

MRH Provider-Based Clinics

The following Memorial Regional Health clinics are provider-based, and a patient or their family member can expect to see a professional bill and an outpatient hospital bill for services received at these locations:

Memorial Regional Health – Medical Clinic
785 Russell Street
Craig, CO 81625

Memorial Regional Health – Specialty Clinic 
600 Russell Street
Craig, CO 81625

  • Family Practice

  • Convenient Care/Walk-In Clinic

  • Pediatrics

  • OBGYN

  • General Surgery

  • Cardiology

  • Internal Medicine

  • Orthopaedics

  • Podiatry

Frequently Asked Questions

A physician practice (Memorial Regional Health Clinic) that the Hospital (The Memorial Hospital) operates, maintains and supports as an outpatient department of the Hospital.

They are costs incurred by the Hospital in operating the practice, (i.e. overhead costs such as electricity, phones, heating, cooling, etc., equipment/supplies, and compensation for non- professional staff. These costs are necessary in order for the Memorial Regional Health Clinic to see and treat its patients.

This clinic is a provider-based practice and based on Medicare guidelines, there is split billing for the professional fee and the facility fee. The Hospital incurs significant cost in operating and maintaining the clinic, and the facility charge helps to cover that cost. The professional fee is for the physician or ancillary provider service. These charges are equal to the amount that would have been billed as a single charge prior to the conversion to a provider-based clinic.

The Memorial Regional Health clinic location where you were treated is an outpatient department of The Memorial Hospital. The Hospital is responsible for the cost to operate and maintain the clinic; therefore, based on Medicare regulations, it is an extension of the Hospital.

We are required to bill you for balances not paid by your insurance company. Your claims were processed based on your benefits for outpatient hospital services and you are responsible for any balance not paid.

Many private insurers recognize and value the integrated care provided to their insured members in provider-based facilities. Such insurers generally follow Medicare’s guidelines in processing provider-based claims. However, claims will be billed depending on the requirements of your insurance policy.

Depending on their particular insurance coverage, it is possible patients may pay more for certain outpatient services and procedures at our provider-based/hospital outpatient locations than at one of our other sites. We recommend patients review their insurance benefits or contact their insurance provider to determine what their policy will pay and what out-of-pocket expenses they may incur.

Patients may contact:

Neita Drake 970-826-8008

Memorial Regional Health offers various payment options. For further details please contact the Financial Counselor at the number listed above.

Financial Aid

Financial Assistance and Sliding Fee Scale Options

Pursuant to Senate Bill 12-134 Hospital Payment Assistance Program Law, below is a list of the financial assistance programs available to patients at Memorial Regional Health.

MRH has a Financial Counselor on staff that screens patients to determine if they are eligible for financial assistance. (MRH tiene un Consejero de Finanzas que chequea a los pacientes para determinar si son elegibles para ayuda financiera.)

Payment Assistance

MRH Discount Program

Memorial Regional Health offers several programs to help patients afford the cost of medical care received at Memorial Regional Health facilities.

Patients who are uninsured, who are below 250% of the Federal Poverty Level, and who do not qualify for the Colorado Indigent Care Program (CICP) may qualify for a discount through the MRH Financial Assistance Program. For more information about this program, click here.

Colorado Indigent Care Program

Some patients may qualify for a discount on medical bills by qualifying for the Colorado Indigent Care Program (CICP).

For more information about CICP, click here.

Additional Financial Assistance

For more information about additional financial assistance, you can download our Financial Assistance Brochure here. You can also contact our Financial Counselor at 970-826-3125.

Contact

Memorial Regional Health
Billie Howe
Patient Financial Services
750 Hospital Loop
Craig, CO 81625
Phone: 970-826-3125
Email

Ayuda para Pagos

Programa de Descuentos MRH

El Memorial Hospital ofrece varios programas para ayudar a los pacientes cubrir el costo del cuidado médico recibido en Memorial Regional Health.

Los pacientes que no tienen seguro, que están por debajo del 250% del Nivel Federal de Pobreza, y que no califican para el Programa de Cuidado Indigente de Colorado (CICP) podrían calificar para un descuento por medio del Programa de Asistencia Financiera de MRH. Para más información, haga click aquí.

Para solicitar un descuento por medio del Programa de Asistencia Financiera de MRH, usted puede “bajar” aquí una hoja de solicitud.

Programa de Cuidado Indigente de Colorado

Algunos pacientes podrían calificar para un descuento de sus facturas médicas si califican para el Programa de Cuidado Indigente de Colorado (CICP).

Para más información sobre CICP, haga click aquí .

Ayuda Financiera Adicional

Para más información sobre ayuda financiera adicional, usted puede “bajar” aquí nuestro Panfleto sobre Asistencia Financiera. Usted puede además contactar a nuesto Consejero de Finanzas en el 970-826-3125.

Contacto

Memorial Regional Health
Billie Howe
Patient Financial Services
750 Hospital Loop
Craig, CO 81625
Phone: 970-826-3125
Email

MRH Financial Aid

MRH Financial Assistance Policy

Memorial Regional Health (MRH) is committed to providing necessary, available medical services to patients with both efficiency and sensitivity to the patient’s medical and financial needs. Patients may be eligible for financial assistance based on financial needs as defined by criteria in the policy. This assistance is available without regard to race, color, creed, national origin, age, disability healthcare condition, or marital status.

Procedure

  • Financial Assistance will apply to the patient’s portion of all medically necessary procedures and services performed at an MRH facility.

  • MRH Financial Assistance will not be given towards services that are not covered within MRH’s scope of services, including, but not limited to: referrals for treatment or specialists outside of MRH.

  • Patients will be required to pay at least the applicable minimum payment prior to service being rendered.

  • MRH utilizes the annually updated Federal Poverty Levels (FPL) to administer the Assistance program.

  • In rare and/or exceptional circumstances, individuals who exceed established income guidelines may be given alternative discounts. These individuals must be referred to the CFO and Patient Financials Services Manager for consideration.

  • If it is determined that a patient misrepresents or provides false information in order to obtain discounted services, this patient and all household members will be denied Financial Assistance.

Applications

  • Applications are available at MRH and will be distributed to patients at the time of service. Applications are also available to anyone upon request.

  • All persons residing in the home are counted as household members.

  • Gross income verification for all persons residing in the home must be provided with the completed application. Appropriate income verification includes: a. Must present most recent year’s tax return. b. If applying after July 1st. Must present pay stubs from the 3 most recent pay periods c. Social Security/Pension Benefit or Award letters d. Bank statement (or bank letter) showing direct deposits e. Interest statements f. Divorce/Custody decrees stating payments to be made g. Foster care/Adoption subsidy agreements.

  • MRH Business Office will review your application and notify you within two weeks of your application.

  • Applications for discounted services will be returned to patient if all documents requested are not attached.

  • All outstanding balances MUST be paid within 24 months depending on the balance.

  • All Adjustments over $10,000 must have CEO approval prior to completion of Financial Assistance Process.

Download an Application

Application – click here.

Sliding Fee Scales

To view the MRH Sliding Fee Scale, click the link below.

Norma de Ayuda Financiera de MRH

El Memorial Hospital y el Memorial Regional Health (MRH) están comprometidos a ofrecer servicios médicos necesarios y disponibles a los pacientes, con eficiencia y sensibilidad a las necesidades médicas y financieras del paciente. Los pacientes podrían ser elegibles para ayuda financiera basada en las necesidades financieras según se definen por criterio en la norma. Esta ayuda está disponible sin que importe raza, color, credo, origen nacional, edad, condición incapacitada de salud, o estado civil.

Procedimiento

  • La Ayuda Financiera aplicará a la porción del paciente por todos los procedimientos y servicios médicamente necesarios efectuados en TMH y MRH.

  • La Ayuda Financiera de TMH y MRH no se concederá para los servicios que no están cubiertos dentro de la gama de servicios de TMH y MRH, incluyendo, pero no limitados a: remisiones para tratamiento o especialistas fuera de TMH y MRH.

  • Los pacientes deberán pagar por lo menos el pago mínimo aplicable antes de que se presten los servicios.

  • Para administrar el programa de Asistencia, TMH y MRH utilizan los Niveles Federales de Pobreza (FPL) acualizados anualmente.

  • En circunstancias raras y/o excepcionales, los individuos que exceden las guías establecidas de ingreso podrían recibir descuentos alternativos. Estos individuos deberán ser referidos al CFO y al Director de Patient Financial Services para su consideración.

  • Si se determina que un paciente falsifica o provee información falsa para obtener servicios con descuento, a este paciente y a todos los familiares en el hogar se les negará Ayuda Financiera.

Solicitudes

  • Las solicitudes están disponibles en TMH y MRH, y serán distribuidas a los pacientes cuando reciban servicios. Las solicitudes están también disponibles a cualquiera que las pida.

  • Todas las personas que residen en el hogar se cuentan como familiares en el hogar.

  • Al completar la solicitud deberán proveer prueba del ingreso bruto de todas las personas que residen en el hogar. Pruebas apropiadas de ingreso incluyen: a) La planilla de ingresos más reciente, b) Si aplica después del 1 de julio, talones de pago de los 3 pagos más recientes, c) Seguro Social/Beneficios de Pensión o cartas de Recompensa, d)Informe (o carta) del Banco mostrando depósitos directos, e) Informes de intereses, f)Decretos de Divorcio/Custodia mostrando pagos que tienen que hacer, g) Acuerdos de subsidio por Cuidado de crianza/Adopción.

  • La Business Office de TMH y MRH revisará su solicitud y le notificará dentro de dos semanas después de haber aplicado.

  • Se le devolverá la solicitud para descuento al paciente si no ha incluido todos los documentos que se requieren.

  • Todos los balances pendientes de pago DEBEN pagarse dentro de 24 meses, dependiendo del balance.

  • Todos los Ajustes de más de $10,000 deberán ser aprobados por el CEO antes de completarse el Proceso de Asistencia Financiera.

Download y Solicitud

Solicitud- haga click aquí.

Escala Ajustable de Cuotas

Para ver la Escala Ajustable de Cuotas de MRH, haga click aqui.

Financial Counseling

We’re Here to Help

Patient Financial Services is excited to have a full time Financial Counselor on staff. Our Financial Counselor assists patients with applications for financial assistance and evaluates their eligibility for state-funded programs, including Colorado Indigent Care Program (CICP). The Financial Counselor is available Monday – Friday to work with patients regarding accounts already due or to help patients plan for an upcoming procedure by sharing information on available payment options. The Financial Counselor also assists patients in finding information on programs within the community other than health care coverage.

For more information or to download a brochure, click here.

Estamos aqui para ayudarle

Consejería Financiera Los Servicios de Patient Financial se complace en anunciar la adición a nuestro personal de un Consejero de Finanzas a tiempo completo. Nuestro Consejero de Finanzas podrá asistir a los pacientes con la solicitud para ayuda financiera y podrá evaluar su elegibilidad para programas financiados por el estado, incluyendo el Programa de Cuidado Indigente de Colorado (CICP). El Consejero de Finanzas estará disponible de lunes-viernes para trabajar con los pacientes en cuanto a las cuentas con balances pendientes o para ayudar a los pacientes planear para un futuro procedimiento, compartiendo con ellos las opciones de pago disponibles. El Consejero de Finanzas también ayudará a los pacientes a encontrar información sobre programas dentro de la comunidad además de cobertura para el cuidado médico.

Haga click aqui para más información o para “bajar” este panfleto.

Contact

Memorial Regional Health
Patient Financial Services
750 Hospital Loop
Craig, CO 81625
Phone: 970-826-3125
Email: Billie Howe