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Billing and Financial Assistance

As a not-for-profit hospital, the mission of Memorial Health System (MHS) is to provide the highest quality health care to all patients, regardless of their ability to pay. Our generous and comprehensive financial assistance program further demonstrates our commitment to serve all members of the community with dignity and respect.


Financial Assistance

Financial assistance is available to the uninsured, underinsured, medically indigent, or financially needy individuals and families under our compassionate care program. Based on income guidelines, patients may qualify for up to 100% write-off of their charges. Please see the Financial Assistance web page to access the Financial Assistance Application and Policy, and the Billing and Collection Policy.

For those who don’t qualify for financial assistance based on current guidelines, other sources of financial assistance may be available, including extended payment plans or discounts for prompt payment of your account. Please contact the business office at (740) 374-1413 to discuss your specific needs. We are here to help.

Memorial Health System depends on prompt payment of bills to meet expenses and continue to provide quality healthcare services to the community.


Hospital Insurance

Memorial Health System will bill your healthcare insurance if you provide the complete information at the time of registration/admission. Please remember that you are ultimately responsible for the payment of all charges.

Pre-certification of insurance coverage is the responsibility of the patient. The authorization form you signed at the time of registration giving us permission to bill your insurance permits us to file your claim with all your healthcare insurance companies.


Patient’s Share of the Bill

Patients will not receive statements until all health insurance companies, which have been identified for the hospital, have been billed and benefits paid. If no response is received from your insurance within 45 days, we will look to the patient/guarantor for payment in full.

Payments for co-insurance, deductibles, or bills denied by your insurance are due upon receipt of your first statement.


Self-Pay (No Insurance)

For non-emergent admissions, you will be contacted by our pre-registration department a minimum of fourteen (14) days prior to the procedure. As part of our pre-registration process, patients will be notified of their financial responsibility. Patients who are unable to satisfy their responsibilities prior to admission are required to work with a Patient Financial Advocate to discuss other payment arrangements and the Financial Assistance programs available. Payment and/or secured financial application is required prior to the procedure.


Personal Injury Claim

Memorial Health System will provide an itemized statement to you upon request to enable you to complete a personal injury claim. Medical records information must be obtained through the Health Information Services department. Responsibility for payment in full remains with the patient/guarantor.


Insurance

Memorial Health System accepts the following insurance and contracted managed care plans.

Insurance and Contracted Health Plans

Are you a health plan provider and want information about enrolling your plans with Memorial Health System?

Contact Inge Chenoweth at (740) 568-5477.


Commonly Asked Questions

How do I get a copy of an itemized bill?

You may call the business office at (740) 374-1413 and an itemized bill will be sent to you.

Will Memorial Health System accept my insurance?

MHS accepts Medicare, Medicaid, and other major insurance carriers. Please contact your insurance company or employer for the specific requirements of your plan.

Will Memorial Health System bill my insurance company/companies

Yes, as a courtesy to you, MHS will send a claim to your insurance company/companies. If we do not receive payment within 45 days, we must look to you for payment of the bill. Your insurance policy is a contract between you and your insurance company. Communication with your insurance company is highly recommended.

Does Memorial Health System accept credit cards?

Yes. Visa, Mastercard, and Discover are accepted forms of payment. You may also pay by cash, check, or money order.

How can I check the status of my account?

If it has been at least 30 days since your date of service, contact your insurance carrier for claim status. After speaking with your insurance company, contact the business office at (740) 374-1413 if you have additional questions regarding the claim.

What should I do if my insurance company denies a claim?

If you feel the claim was denied in error, contact your insurance carrier for instructions on how to appeal their decision. The business office should also receive an explanation of benefits (EOB) from your insurance company stating the claim was denied. This information will be reflected on your account, and you will receive a statement requesting payment in full.

How will I know if my hospital bill has been paid?

Your insurance company should send you an explanation of benefits (EOB) indicating they have processed the claim. The EOB will show any payments made to the hospital and the amount that is your responsibility. You will receive a statement from the hospital once all insurances have been processed. This statement will reflect all insurance payments, adjustments, and the balance remaining. Any remaining balance is your responsibility.

What if I cannot pay my bill?

To set up payment arrangements on your healthcare bill, contact Help Financial at (800) 752-9613 immediately upon receipt of your statement. Call (740) 374-1413 to speak with the Patient Representative regarding MHS payment guidelines.


Financial  Assistance

We can work with you to secure financial assistance for your care.

Financial Assistance is available for qualified patients. It is important to let us know before you visit if you do not have health insurance or if you are unable to pay for your services in full so that we can help ensure you receive all the financial support for which you are qualified. All applications for financial assistance should be completed as soon as possible.

To apply for financial assistance, please complete a Financial Assistance Application and return it to us as directed on the form. The Plain Language Summary and the Financial Assistance Policy further explains the process, qualifications, and how to get additional information regarding financial assistance.

Memorial Health System offers trained financial counselors who can help determine if you might qualify for an assistance program. Our counselors are available by calling (740) 568-5263 from 8 a.m. to 4 p.m. or emailing financialassistance@mhsystem.org.

Financial assistance programs offered include:

Medicaid provides health coverage to millions of Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Each state sets individual eligibility criteria and requires patients to complete an application form. We will help qualified patients complete our application process at no additional charge.

Hospital Care Assurance Program (HCAP) provides free care to Ohio residents who are not receiving Medicaid benefits and whose income falls at or below the federal poverty guidelines. This program only covers hospital services that are deemed medically necessary by your physician. We will help qualified patients complete our application process at no additional charge. Please see the link above for access to the financial assistance application and policy.

Other financial assistance may be available to patients who are not residents of Ohio and/or whose income is above federal poverty guidelines. Please see the link above for access to the financial assistance application and policy.

Memorial Health System not-for-profit facilities have adopted billing and collection policies appropriate to their patients’ circumstances.


Open Door Policy

Memorial Health System has an open-door policy – no patients are denied admission because of their inability to pay for services. Also, federal and state regulations require that the hospital furnish free care to patients with income at or below the poverty level. Proof of income may be required. Please call our Financial Counselor at (740) 568-5263 between 8 a.m. – 4 p.m., Monday through Friday for more information.


Workers’ Compensation

The hospital will bill the patient until a valid claim number is obtained and given to Patient Accounts. The claim number enables us to bill Workers’ Compensation for your care. The patient will be billed if the claim is denied by Workers’ Compensation. Non-covered services will remain the responsibility of the patient unless personal health insurance information is provided to Patient Accounts.

If you have questions concerning a Workers’ Compensation claim, please email: wc@mhsystem.org.


Courtesy Discharge

Patients will be extended a courtesy discharge permitting them to leave the hospital without clearing through the Cashier’s Office if the following requirements are met:

  • Insurance has been verified and all appropriate forms are signed
  • Satisfactory financial arrangements have been made

The hospital accepts personal checks, Visa, MasterCard, and Discover as payment.


Point of Service Payment

Most people want to know the cost of their medical services, but do not know how to access the information. Knowing the cost of a service up front enables you to make informed decisions about your health and care. In recent years, hospitals have introduced programs to provide easier payment methods for patients. One program is called Point-of-Service Payment, and it consists of patients paying their portion of the bill at the time of service or immediately after services have been delivered.

Memorial Health System announced the implementation of a payment process that helps patients know and understand the cost of their medical care before receiving services in non-emergent situations. As part of its financial transparency to the community, the health system’s software tool offers real-time cost estimates for co-pay, co-insurance, and deductibles so patients can make informed decisions about their health care.

Q&A for Patients

Why has the hospital implemented this program? I was never asked to pay at the time of service before.

Today, most service organizations require payment at the time of service, including hospitals. This is done primarily for three reasons:

  1. Providing patients’ information about their expected portion of the bill upfront allows them to make informed decisions.
  2. A significant portion of a hospital’s revenue is from insured patients’ co-payments, deductibles, and non-covered procedures, as well as payments from patients without insurance.
  3. By collecting payments at the Point-of-Service, hospital operating costs are kept down since collecting after patients leave the facility can be both costly and time-consuming. These savings are then reinvested to help operate the hospital and pay for new medical technology–all of which benefit our patients and community.

How can I pay my portion of the bill?

For your convenience, we take cash, checks, and credit cards (Visa, MasterCard, and Discover). Our representative can help you complete this process. We participate in many programs to assist our patients with their financial responsibility, including a discount of 15% pre- and at the time of service.

How does the hospital determine my payment?

For scheduled services, the hospital will call and verify insurance coverage in advance and notify the patient what their portion of the bill will be. In addition, many insurance plans list the co-pays for various services, such as emergency room visit co-pays, on the insurance card. The main difference between Point-of-Service and other payment programs is that we ask for your portion of the bill while you are at the hospital rather than billing you later.

For elective procedures, will I know my portion of the bill before I get to the hospital?

We will make every effort to contact your insurance company so that you will know the balance due at the time of service. We will ensure that pre-certification is obtained for you, which ensures that you have met the various criteria that insurance companies sometimes require for certain services before they will agree to pay. We do this on your behalf to help ensure your insurance company will not deny your claim, which could leave you responsible for the entire bill.

What if I am in a financially difficult situation?

We understand that sometimes paying deductibles or co-pays can be difficult due to life situations. If you need assistance with payment options, you will be referred to a representative who can help identify possible financial assistance such as Medicaid or any other federal, state, or local benefits coverage. The representative can also help develop a payment plan that is satisfactory to both the patient and the hospital. We participate in many programs to assist our patients in their financing including a prompt pay discount of 15%. This helps relieve the stress of worrying about bills at a time when you need to focus on getting well.

What if I come to the hospital in an emergency?

The first priority of any emergency room nurse or physician is to care for patients and do everything possible to help them during an emergency situation. With that in mind, after a medical screening examination has been performed and the patient is determined not to have an emergency medical condition, the registration clerk may ask for payment.

What do I need to bring with me to the hospital now?

To assist the hospital in determining the proper amount due at the point-of-service, patients should bring insurance cards, as well as their Social Security number and photo identification (such as a driver’s license). The registration clerk will use this information to confirm with your insurance provider what your co-payment and deductibles are for the services you are receiving. Patients should also be prepared to pay by bringing their checkbook, credit card, etc.


Provider-Based Billing

Provider-Based Billing for Medicare and Medicaid Patients

Thank you for being a valued patient at one of Memorial Health System’s employed (provider based) physician locations. These physician locations now function as departments of Memorial Health System.

What is Provider Based Billing (PBB)?

PBB refers to the billing process for services rendered in a hospital department or location. This process takes place when the hospital owns space and employs physicians and other support personnel who are involved in patient care.

Will there be a change in how patients receive care?

No. Patients will continue to receive excellent quality care with their physician, and scheduling appointments and tests will be handled as they always have been in the past. However, there is a change in how the hospital will bill your insurance carrier for these services.

How does this affect the billing process?

Because care is provided in a department of the hospital, patients will receive a bill from Memorial Health System as well as a separate bill for the professional services provided by their physician. This also includes physicians who interpret the results of diagnostic tests.

Medicare beneficiaries are responsible for the co-insurance amount on the services they receive. These amounts are determined by Medicare and are based on the services performed.

Will Medicare patients have to pay more for services?

Some Medicare patients may be covered by their supplemental insurance and will not have to pay more out-of-pocket, but Medicare patients without supplemental insurance may have to pay a small amount. Patients with other health insurance should check with their insurance provider and ask whether it covers facility charges or Provider Based Billing. Depending on specific insurance benefits, additional out-of-pocket expenses may be incurred by Provider-Based Billing.

Where can patients call for more information?

Contact a financial counselor at (740) 374-1413.


Understanding Your Statement

You will not receive a statement until your insurance company has considered your claim. The statement will reflect all hospital services you received during your treatment and will indicate any payment made by your insurance company, as well as any adjustment per the terms of your insurance contract. The amount of your self-pay balance will be shown in a box at the top of the statement, along with the date payment is due. (Please note that you may receive an itemized bill at any time by calling our business office at (740) 374-1413.)

You may receive statements from physicians that treated you as well as physicians that you did not see in person. These charges are for professional services (such as interpreting your test results). Pathologists, radiologists, cardiologists, anesthesiologists, and other specialists are required to submit separate bills to you. Should you have questions concerning the physician’s bill, please contact them directly. To assist you, we have listed the most frequently requested telephone numbers below.

 

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