Accounts, Billing, & Insurance Information
Account Questions
For Questions relating to Hospital Accounts, Insurance, payments or explanation of benefits, please contact a receptionist for transfer to the correct representative. If you are hospitalized you may receive multiple statements from the hospital and/or physicians who treat you during your hospital stay. Patient account representatives are available to assist you with the financial aspects of your hospital statement, staff will be glad to help you in explanation of services and determining your responsibility thereof. If you do not find the answer to your particular question, please contact us at 660-542-1695.
Medical Cost Estimate
In the event you do not have insurance, you may want to compare costs of our facility to other facilities. We invite your request as we feel that our charges are as competitive as any hospital within the state. If you need an estimate of charges for services you know you will be receiving, please contact a patient account representative for an estimate prior to receiving services.
Payment (s) to Hospital
You and/or your personal guarantor are responsible for payment of your hospital account. Financial arrangement may be discussed at the admissions and business office and or patient account representative. While you may have insurance, your insurance plan may or may not pay for all services therefore you or your guarantor shall ultimately be responsible for all incurred services.
CCMH has a payment policy requiring verification of payment for all services except emergency services. This policy applies to all patients.
For your convenience, CCMH accepts cash, wire transfer, personal, traveler’s or Cashiers checks, Discover, Master Card or Visa credit cards. Call 660-542-1695 for payment by phone or you may choose to make your payment online by clicking here.
CCMH has charitable and uncompensated services policy. Individuals meeting poverty and other guidelines may make application for reduced or free services. Please contact the patient account representative for information regarding qualifications and application guidelines.
Medical and Hospitalization Insurance
CCMH will file your primary and most secondary insurance claims for you. If you have coverage with more than one insurance company, it will be your responsibility to coordinate billing and payment information with them.
It is imperative that “CORRECT” information be given at the time of rendered service. Any incorrect information will most likely hold you totally responsible for your account. CCMH will be glad to assist in the filing and billing of all viable insurance companies.
Insurance coverage varies among individual insurers and individual policies. Many insurance companies limit payments using their own fee schedule of “usual, customary and reasonable (UCR) allowances. CCMH’s fees/charges may differ from insurance companies fee schedules. We suggest that you check with your employer or insurance agent about coverage. We do not treat insurance companies, we treat patients who are directly responsible for payment of their accounts regardless of the amount paid by the Insurance, including balances due to UCR limitations. If you do not have insurance or have an outstanding account, a pre-service deposit may be requested.
Medicare
Medicare has two billing parts. Medicare Part A (Hospital Insurance) helps pay for inpatient hospital services. Medicare Part B helps to pay for outpatient hospital services and physician fees.
Medicare Coverage(s)
If you are hospitalized, your Part A (hospital inpatient) and Part B (hospital outpatient) claims will be filed to Medicare for you. These payments will be sent directly to the hospital. You will receive a “Medicare Summary Notice” from Medicare after they process your claim. If you have supplemental or Medigap hospital insurance, the hospital will file all supplemental coverage AFTER Medicare has made payment.
If you receive Outpatient services, we will file claims to Medicare. If you have other supplemental insurance that covers out patient services we will file a claim only AFTER Medicare has made payment.
Medicare Secondary Payer Coverage
If you have insurance coverage (co-insurance) secondary to Medicare, please provide this information to CCMH at the time you are asked to provide insurance information. Secondary Insurance policies normally pick up the deductibles and co-insurance that Medicare and other insurance companies fail to cover.
Medicaid
CCMH participates in and accepts Medicaid of Missouri. This participation allows CCMH to provide services to - and bill Medicaid of Missouri for - services provided to patients from Missouri. CCMH will verify that Medicaid coverage exists prior to providing such services. Medicaid and most Medical Assistance programs require that some services receive prior authorization before payment is allowed. This may cause a delay in receiving services other than those of an emergent nature.
Medicaid - Other States
CCMH is unable to provide non-emergent services to Medicaid patients from other states. If you are covered by Medicaid or other Medical Assistance sponsored by another state, you may be responsible for any costs related to emergency services provided at CCMH. You may then file a claim with your individual state plan for those charges.
Workers Compensation Claims
All worker compensation claims shall be verified with the patient’s employer PRIOR to receiving services, unless it is an emergency. Pending claims shall be the total responsibility of the patient unless paid by workers compensation insurance.
Managed Care Plans
If you coverage is through a managed care plan including HMO’s, you will likely need a referral from the health care plan in order to receive coverage at CCMH.
Your primary care physician may assist you in obtaining a referral from your insurance company. We recommend that you check with your plan PRIOR to receiving services.
Marketplace Plans
CCMH offers, at no cost, assistance with navigating the healthcare marketplace and working with you to find a policy that best suits your needs. These services are available during the open enrollment period each year (November - December). To set up an appointment with one of our Certified Application Counselors (CAC), please call 660-542-1695, ext. 3013.
Discounts
Unlike other hospitals that escalate hospital bills then allow discounts, Carroll County Memorial Hospital philosophy is to maintain the lowest possible charge. Therefore it is our policy to not give discounts to individuals except on a charitable basis, which is based on minimum poverty, and guidelines set forth by the government and CCMH.