Hospital Bills and Insurance
Good Shepherd Medical Center is a not-for-profit facility that is not supported by any taxing authority, and therefore relies on the revenues it collects from payors and patients. As part of our mission to serve our community we must also meet the financial obligations that come with this responsibility. You will be asked for payment for services in advance as appropriate, and offered options to assist you in satisfying your financial responsibility.
If You Have Health Insurance
If You Are a Member of an HMO or PPO
If You Are Covered by Medicare
If You Are Covered by Medicaid
If You Do Not Have Insurance
If You Need Financial Assistance
Patient Financial Services
Your Hospital Bill
Previous Page
If You Have Health Insurance
Your identification card or a copy of your health insurance card will be required. The insurance forms supplied by your employer or the insurance company may be necessary. You will be asked to sign a form directing your insurance company to pay the hospital directly.
If there is a question about your insurance coverage, a member of the Patient Financial Services Department will contact you or a member of your family while you are here. Insurance information is needed in order to process your medical bill.
If You Are a Member of an HMO or PPO
Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your healthcare plan, and their services may not be covered.
If You Are Covered by Medicare
We will need a copy of your Medicare card to verify eligibility and process your Medicare claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations, self-administered drugs, and others. These costs, along with deductibles and co-payments, are the responsibility of the patient.
Medicare has set rules that determine whether a patient is inpatient or outpatient. A patient must meet certain criteria set by Medicare to be considered inpatient. Our Case Management department works closely with your physician to ensure the compliant and appropriate status. Please be aware that observation is considered an outpatient service, which is covered under Medicare’s Part B guidelines. While under observation, you may be in the hospital for up to two days. If you are considered observation, you are responsible for medications that Medicare considers to be self-administered.
If You Are Covered by Medicaid
We will need a copy of your Medicaid card. Medicaid also has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless medically necessary.
If You Do Not Have Insurance
A representative from Medical Third Party Resources will discuss financial arrangements with you. They will assist you in completing applications for all local, county, state and federal financial aid. To contact a representative, please call 903-315-5200.
If You Need Financial Assistance
A representative from the Business Office can work with you to establish a no interest payment plan. They can also evaluate your personal situation to determine if you qualify for Good Shepherd Medical Center’s Financial Assistance Program. To discuss this program, please call 903-315-5200.
Patient Financial Services
A representative from the Patient Financial Services Department can answer questions about your hospital bill and help you interpret the financial policies and billing procedures of the hospital. You can make a payment at any registration area. You may contact Patient Financial Services by calling 903-315-5200 or 800-766-4762 Monday through Friday from 8 a.m. to 5 p.m.
Your Hospital Bill
If you have certain tests or treatments in the hospital, you may receive bills from physicians you did not see in person. These bills are for professional services rendered by physicians who diagnose and interpret test results such as pathologists, radiologists, cardiologists, anesthesiologists and other specialists. These specialists are required to submit separate bills. If you have questions about these bills, please call the number printed on the statement you receive from the individual physician.
|
