Billing and Insurance

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

If you don’t have insurance or don’t intend to use insurance to pay for scheduled non-emergency health care services, federal law requires that health care providers and facilities provide you with an estimate of the expected charges for medical items and services at least 1 business day before the scheduled services are to be performed.

• If you are uninsured or not using insurance to pay for your health care services  and receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Any patient may request an estimate of the expected charges for non-emergency health care services that have been ordered, scheduled or referred and state law requires that health care providers and facilities provide you with an estimate of the expected bill for medical items and services within 5 business days of the request.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• If you request an estimate and the actual charge for the health care services exceeds your Good Faith Estimate by the greater of: (i) $100; or (ii) 5%, we will provide a written explanation as to why the charges exceed the estimate.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.

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How can I get in contact with the Patient Accounting Department?
Phone:833-432-0207
Fax: 765-932-7505

What forms of payment do you accept?
We accept:
Cash
Personal Checks, Cashier’s Checks, and Money Orders
Credit and Debit Cards
Healthcare Savings Accounts

Why did I receive bills from different companies for the same visit?
A patient who receives services from Rush Memorial Hospital may receive more than one billing statement for those services. You will receive a hospital billing statement for the services that were rendered to you at the hospital as well as a separate bill for any Pathology or Emergency Room physician services.

The Emergency Physicians’ Bill is separate from the hospital bill. When you receive a statement from Rush Memorial Hospital for an emergency room visit, it will only pertain to charges incurred for the use of the Emergency Department treatment area, technical and ancillary personnel, supplies and equipment.  It will not include the Emergency Physicians’ fees.  The patient will receive an additional statement for the professional fees for the clinical and diagnostic evaluation, treatment and/or supervision of care. Vituity will bill the appropriate insurance company for services rendered and if there is a balance remaining, the patient will receive a statement directly from CEP America, LLC.  If you have any questions regarding a statement received from this company, you will need to call 800-498-7157.

Additional billing statements (other than your hospital billing statement) will have the phone number of the specific billing office for questions regarding that statement. (Note: Services rendered by providers other than the hospital may not be covered by your insurance carrier. Check your policy for details.)

The insurance listed on my bill isn’t the right one. How can I change it?
First, check to see if the insurance company that you had on that date matches the date of service on the bill. If it is an incorrect insurance company or policy number, please contact our Business Office Center at 833-432-0207. The Business Office Center is available Monday through Thursday from 8:00 am to 6:00 pm and Friday from 8:00 am to 5:00 pm.

Why do I need to call the insurance company if they do not pay the bill?
The patient is ultimately responsible for the total bill or a portion of the bill your insurance carrier does not pay. Our Patient Accounting Department will make every effort to resolve the account balance with your insurance carrier. Occasionally, we will be unable to resolve the issue with your insurance provider and will need your assistance.

Would I be able to get on a payment plan if I can’t afford to pay my bill all at once?
Rush Memorial Hospital has several payment options and any of our Business Office Representatives will work with you to set up a payment plan that is most appropriate.  Long term payment arrangements as well as Financial Assistance is available for qualifying balances. The Business Office is available Monday through Thursday from 8:00 am to 6:00 pm, and on Friday from 8:00 am to 5:00 pm.  Please call 833-432-0207.

Does Rush Memorial Hospital offer any discounts for patients without insurance?
A “Prompt Pay Discount” of 15% for insured accounts will be offered if the account is paid within 30 days of receiving the first statement. Self-pay accounts are eligible for a 25% discount if paid within the first 30 days.  If you would like more information on these discounts, please contact our Business Office Center at 833-432-0207 and any of the representatives will be able to assist you. The Business Office Center is available Monday through Thursday from 8:00 am to 6:00 pm, and Friday, 8:00 am to 5:00 pm.

I can’t afford to pay my balance. What can I do?
Patients’ balances due resulting from limited or no insurance coverage may qualify for financial assistance. If you would like more information on this program, please contact our Business Office Center and our representatives will be able to assist you. The Business Office Center representatives are available Monday through Thursday from 8:00 am to 6:00 pm, and Friday from 8:00 am to 5:00 pm.  Please call 833-432-0207.

What is a deductible? Coinsurance? A co-payment?
A “deductible” is an annual expense that you must pay before your insurance benefits can begin. This amount can vary based on place of service (i.e. your doctor’s office vs. a hospital). Supplemental Insurance Plans may cover this.
“Coinsurance” is the portion of the total bill (usually a percentage) that is the patient’s (or guarantor’s) responsibility to pay. This amount can vary based on place of service (i.e. your doctor’s office vs. the hospital).
A “Co-pay” is a set amount paid each visit, based on your insurance policy. This usually does not count toward your deductible.

I have Medicare which usually covers my entire bill. Why am I being billed for some of my visit?
You are responsible for any applicable deductibles, co-payments, or other amounts not paid for by Medicare.

How can I tell if I have a Co-Pay?
You can check with your insurance provider to see if you have a Co-Pay. Also, this information could possibly be found on your insurance card.

Rush Memorial Hospital is contracted with the following health insurance plans listed below:

• • AARP Medicare Advantage
  • Aetna
  • Aetna Medicare Advantage
  • Allwell (Medicare Advantage Product of MHS)
  • Ambetter Marketplace – Product of MHS (Plans Include: bronze, silver, gold and platinum)
  • Anthem BC/BS (Alpha Prefix varies per employer)
  • Anthem HIP (Healthy Indiana Plan)
  • Anthem Medicaid
  • Anthem Medicaid Hoosier Care Connect
  • Anthem Marketplace – (Plans Include: bronze, silver, gold and platinum)        
  • Anthem Medicare Advantage
  • Care Source Medicaid & HIP
  • Care Source Marketplace –  (Plans Include: bronze, silver, gold and platinum)
  • Champus
  • CIGNA
  • Cigna Medicare Advantage
  • Community Health Alliance – Prohealth / ENCORE
  • Encore
  • Envision
  • First Health PPO Network
  • Humana PPO
  • Humana Medicare Gold Plus PPO
  • Humana Military
  • IU Health Plan (Commercial) Uses Encore Contract
  • MDWise Medicaid & HIP (Healthy Indiana Plan)
  • Medicaid (Traditional – state-sponsored)
  • Medicare (Traditional)
  • MHS (Managed Health) Medicaid & HIP
  • PHCS PPO
  • Sagamore Health Network
  • SIHO
  • Tricare
  • UMR
  • United Health Care
  • United Health Care Allsavers
  • United Health Care GEHA Secured Services
  • United Health Care Golden Rule
  • United Health Care Hoosier Care Connect (Medicaid)

*Note: Rush Memorial Hospital does not accept or have contracts with the following
ELAP, Non-Network (Contracted) Plans or Limited Benefits Plans
Humana Medicare Gold Plus HMO Insurance

*Subject to change.