Understanding Your Bill
Crawford County Memorial Hospital is committed to making each patient’s experience a positive one. Understanding insurance and billing procedures is part of that process.
Because Crawford County Memorial Hospital works with a company called Trubridge for patient billing services, your hospital bill will be sent to you directly from Trubridges’ office in Mobile, Alabama. When your bill arrives, the return address on the business envelope will say Crawford County Memorial Hospital and your payment is processed at our facility. Even though the bill is generated in Mobile, be assured that our local business office staff has the original record and is on hand to answer any questions you may have about payment.
The bill you receive will be for services performed at our facility. You will not obtain a separate bill for hospital and clinic services. There may be times where you receive additional billing from a third party such as Physician’s Laboratory, PC or Nebraska Iowa Radiology Consultants.
Crawford County Memorial Hospital has a long history of providing assistance to help relieve the financial burden of accessing much needed services for our local uninsured or underinsured patients. Our financial counselors would be happy to provide information on payment plans or provide more information on applying for aid through our charity care program. Our charity care program is based upon federal poverty guidelines. After completing an application, patients who qualify will have a percentage of or the entire bill forgiven.
For more information, call 712.265.2500 and ask to speak with our financial counselors.
Patient Financing Options
Crawford County Memorial Hospital is pleased to offer Platinum Patient Financing! Platinum financing gives our patients on-the-spot financing when it’s needed to pay medical expenses. It’s fast, flexible, and affordable. Best of all, it’s offered locally through the GreenState Credit Union.
- 0% APR* for 6 months introductory rate
- Minimum payment required
- Flexible repayment options
- No prepayment penalty
- Loan terms available from 6 months to 60 months with rates as low as 9.99% APR
- Fixed monthly payments for the term of the loan
- Flexible repayment options
- No prepayment penalty
*APR is Annual Percentage Rate. Rate is fixed (non-variable). Interest rate is based on credit score, capacity to repay and approval. No prepayment penalties. Crawford County Memorial Hospital offers closed-end personal installment loans for the terms listed above only.
Questions? Contact our Financial Counselors at 712.265.2500
Questions About Your Bill
Yes. The Crawford County Memorial Hospital has financial assistance available for anyone that qualifies. Please call (712) 265-2500 and ask for an application. You may also stop by the Business Office at the hospital and request one from the staff.
No to both of these questions. The hospital uses the service of a company to call our patients who have received statements from us. The purpose of the call is to assure that any questions regarding the bill are addressed and to help the patient establish a payment plan, if needed.
Yes. There are certain policies that apply to monthly payments. Please call (712) 265-2510 for help in establishing a payment plan.
In some situations, particularly for specialists holding clinics in our outpatient area, you may receive a bill from the hospital and the physician. When this happens, it is because national billing rules require that the physician not include the cost of overhead in the fee that he charges you, while they require that the hospital bill for this overhead.
Emergency Room visits are meant to provide urgent services with little or no notice. As such, the cost of staffing the Emergency Room is much higher than staffing a physician office. When a patient presents in the ER, hospital staff have to perform a thorough assessment of the patient, even if you, the patient, feel that you know what the problem is. For example, a patient presents to the hospital with a bad cough and tells the ER staff that they know they have bronchitis and just need something for the cough. The hospital’s legal, ethical and moral obligation is to 1) verify that the patient has bronchitis and 2) verify that there are no other conditions contributing to the cough. Therefore, it is possible that the ER staff will order lab tests, radiology tests and maybe even an EKG, depending on the staff’s evaluation of the patient. Each of these add to the cost of the ER. In addition, the patient’s bill includes the hospital charges (for the ER room and all ancillary tests) and a charge for the physician, nurse practitioner, or physician assistant who provides the actual treatment. Another factor that will affect the amount ultimately billed to the patient is the patient’s own insurance coverage. Today’s insurance policies often pay a smaller percentage of an ER visit if the company feels that the patient could have waited and obtained care from a physician office. In the example of the patient with bronchitis, it is possible that the insurance company would pay a lower percent and increase the patient’s responsibility.
Questions About Your Insurance That May Affect Your Bill
If you are covered by insurance or Medicare, you will receive an Explanation of Benefits from the company. You will not receive a statement from the hospital until we have heard from your insurance company. That statement should agree with the information you received from the insurance company. In order to assure that this insurance information is accurate, it is very important that you provide us with updated insurance information. If you do not have insurance, you should receive a statement within 60 days of your services.
The length of time for claims to be processed by an insurance company can vary. One of the primary considerations is when the hospital submits the claim. It can take anywhere from 7 days to a month for the hospital to send the claim to your insurance, depending on the type of services provided and physician documentation. Once the claim has been submitted, most insurance companies process payment within 2-4 weeks. However, claims involving liability questions or the need for additional documentation may take longer. If you are covered by more than one health insurance policy, the claim to the second insurer cannot be sent until the primary payer has finished correctly processing the claim. It is also important that, if you receive any correspondence from your insurance company asking for additional information, you respond quickly, as the claim will be held until your answer is received.
Medicare is designed to cover a broad spectrum of services for Medicare beneficiaries. However, by federal statute, there are certain services and items that are not covered. The most common of these is self-administered drugs. When you are an outpatient (in the specialty clinic, outpatient surgery, the emergency room or observation), Medicare prohibits us from billing Medicare for any drug that can be self-administered by the majority of patients. This would include tablets, liquids, salves and creams, and inhaled medication. It also includes insulin. With the exception of insulin, it does not matter whether the individual patient is capable of administering the medicine, only that the medicine be classified as self-administered. Insulin will be covered in a case where a patient is in a diabetic coma. Other instances where you may receive a bill after Medicare and your supplement has processed a claim is when the hospital informed you prior to the service that we felt that the particular service does not meet Medicare’s Medical Necessity Rules or their frequency guidelines. In these cases, we would require you to sign an Advanced Beneficiary Notice (ABN) prior to the service, either refusing the service or acknowledging that you will be responsible for the cost.
Under the rules of the Patient Protection and Affordable Care Act (PPACA), many insurance companies do cover the cost of an annual wellness exam. However, it is important to know what this wellness exam is not. The rules apply to visits for “symptom-free and disease-free individuals”. Conditions which require additional evaluation or treatment are not considered preventative in nature. If you require an additional evaluation or treatment, an appropriate office visit charge will also be submitted to your insurance company. If you, with the recommendation of your healthcare care provider, decide to have lab work performed, your insurance company will receive a separate claim for all the lab work done. These services may or may not be covered by your insurance company. Be advised that “screening’ is designed for a person who has not yet been diagnosed with a particular disease. For example, your insurance company may allow for lipid screenings on an annual basis to determine if you have high cholesterol. If it is determined that you do have hyperlipidemia, you may not be screened for it any longer. Your provider will order periodic tests to monitor your condition to check the efficacy of your medication, diet, and exercise program, but once you have the disease, you may no longer be eligible for free screenings. By the same token, your provider may decide to order a screening lab test, such as potassium, that, while it is screening, is not 100% covered by your plan. Just because a test is ordered as a result of an annual wellness exam does not guarantee that the screening is a free preventive service covered by the PPACA. It is also possible that you presented to the office requesting a physical required by your employer or for a DOT physical. If the intent of the office visit is to have a work physical, health insurance companies will frequently deny coverage for the visit. If a patient presents for an annual wellness visit and asks for an employment physical form to be completed at the end of the visit, it will be up to the provider to determine if the annual wellness visit covers everything required by the employment physical. If the employment physical requires additional assessment, the visit will be considered an employment physical and not an annual wellness exam. This is always true with a DOT physical.
There are times that the VA and/or ChampVA will require the patient cover some or all of the cost of services. For example, if services are provided in the emergency room and the VA determines that the patient could have safely sought treatment at the Emergency Department of a VA hospital, the VA will not cover the visit. Neither will the VA cover outpatient services that have not been preapproved by the VA. ChampVA often has a coinsurance/copay required for certain outpatient services.