To Our Patients
For many patients and their families, a visit includes filling out unfamiliar forms and answering financial and insurance questions. The information below and the phone numbers that follow can help with this process.
Heartland Health will honor assignments of insurance benefits for 45 days from the date of billing to the insurance company. If, at the end of 45 days, the insurance company has not settled the account, Heartland Health will look to the patient for the final settlement of the account.
Any patient having inadequate insurance coverage, or no insurance coverage, will be requested to make appropriate deposits at the time of admission.
Your Insurance Identification (I.D.) Card
To enable Heartland Regional Medical Center to bill your insurance company directly, you will be asked to provide your insurance identification (I.D.) card(s). In the event of a true emergency, the card should be presented as soon as possible following admission. You will also be asked to provide any claim or referral forms required by your insurance company.
Heartland Regional Medical Center is a participating hospital provider in numerous major managed care organizations.
Note: Failure to provide accurate and current insurance information and required referrals when you are admitted could result in penalties or a reduction of benefits by your insurance company.
Your insurance and Medicaid coverage
There may be some services or supplies your insurance will not pay for. Should this occur, you will be billed directly. To apply for Missouri Medicaid, please contact a HCFS representative at (816) 271-7524.
Pre-certification
Most insurance companies require pre-certification, or approval of admission before a scheduled hospital stay and various outpatient exams. It is the admitting physician's responsibility to contact a patient's insurance company to complete those requirements before service. Ultimately, you are responsible to notify your insurance company before arriving.
Emergency admissions must be "pre-certified" by contacting your insurance company as soon as possible (usually within 24 hours).
Note: Failure on your part to pre-certify with your insurance company could result in a reduction of benefits, or in some instances, a denial of payment by your insurance company for your hospital stay.
Benefits
Many insurance companies limit the number of days of hospitalization that they will cover, and may limit certain hospital services. Please contact your insurance company for complete information about your benefits and coverage.
Second Surgical Opinions
Many insurance companies require a second surgical opinion prior to approving surgery. Please check your insurance policy to determine if this is required.
Discharge Planning
Discharge planning often begins when you are admitted. During your hospital stay, your care is monitored by a nurse case manager and, when indicated, by a social worker from Care Management. The case manager maintains contact with your insurance company to review your plan of care and assess your needs. The social worker will assist you in planning your discharge and arranging any post-discharge needs that you may have.
Medical Necessity
This term refers to those services, as defined by your insurance company, that are medically appropriate in a hospital setting. Your insurance company may determine that some or all of the services that you receive during your hospital stay are not "medically necessary." Should this occur, you should receive notification from your insurance company that these services may not be payable by your plan, as well as a letter from Heartland outlining your financial responsibilities for these services. For more information, contact Patient Financial Services at (816) 271-7524.
Denials and Appeals
Heartland Health maintains an Appeals process to review non-coverage decisions related to your visit. Patients continue to remain responsible for deductibles, co-insurances or other charges outlined in your health care insurance policy.
Financial Assistance
For patients who are unable to pay the full amount, Heartland has a program that may help pay the healthcare services. Applicants will be evaluated for possible Medicaid eligilibility and may be required to formally apply through the Division of Family Services for Missouri Medicaid or contact a HCFS representative at (816) 271-7036. An application for Financial Assistance can be made with Patient Financial Services by calling (816) 271-7524. Patients may apply Monday through Friday, 8 a.m. to 4 p.m. or inquire by phone (816) 271-7524. Patients outside the St. Joseph calling area should call 800-447-1095, please stay online for the next available representative.
To request an itemized bill (detailed charges)
At the patients request, Heartland will provide an itemized bill. Please call Patient Financial Services at (816) 271-7524.
If You Have Questions
If you have further questions, please do not hesitate to call any of the following departments for assistance.
Centralized Scheduling
(816) 271-1278 or 800-443-4515
8 a.m. - 5:30 p.m., Monday - Friday
Health Access Department
(816) 271-6579 or 800-447-6827
8 a.m. - 5:30 p.m., Monday - Friday
Pre-Certification
(816) 271-6642
8 a.m. - 5 p.m., Monday - Friday
Patient Financial Services
Hospital and Heartland Clinic Billing: (816) 271-7524 or 800-447-1095
8 a.m. - 4:30 p.m., Monday - Friday. |
