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Meadville Medical Center | MMC Foundation | Hospice of Crawford County | Locations | Payments

Payments



Billing Process
During the admissions and registration process, you will be asked questions about your current insurance. Please bring along any necessary insurance information, such as enrollment cards. Your insurance cards are important because they let us know if there is a need for a pre-certification or if a co-payment is part of your plan. They also provide us with the insurance numbers and addresses for billing. The Business Office will bill both primary and secondary insurance companies for all inpatient and outpatient services. If you have more than one insurance, please let us know. You will be asked for a driver's license or photo ID to verify your identity. Please bring either one with you so that the registration clerk may copy or verify your personal information.

Financial Facts
Most patients have some type of health insurance to help pay their hospital bill. However, very few health insurance programs pay the entire bill. The following guidelines may assist you in settling your account. If you have questions regarding your insurance coverage or your bill, contact our Business Office.

Blue Cross and Medicare
Both are billed directly by the hospital Business Office. Payment is made directly to the hospital. Any balance due will be payable as indicated under SELF-PAY.

Commercial Insurance
Both group and individual insurances are billed directly by the hospital Business Office. It is required that you sign an authorization to pay insurance benefits directly to the hospital. Unless the account is paid in full, the balance due will be payable as indicated under SELF-PAY.

Medical Assistance
It is required that you present your current active medical card at the time of admission to the hospital. Otherwise your account will be payable as indicated under SELF-PAY.

Self-Pay
All balances due are PAYABLE IN FULL AT THE TIME OF DISCHARGE.

Financial Assistance Program
Many patients qualify for a reduction in fees owed if financial need is proven.  If an individual is unable to make monthly payments and feels he or she could qualify for this benefit, then he or she should contact any Financial Counselor to discuss options.  A Financial Counselor is available Monday-Friday, 7AM til 3:30 PM.

Itemized Bills
If you or your insurance carrier requires an itemized bill for services rendered at Meadville Medical Center.  If you are requesting a bill on behalf of a patient, but do not hold the Power of Attorney for the patient, the patient must sign a “Release of Medical Records” to do so.  If you hold the Power of Attorney for a patient, you must sign the release and provide legal documentation showing proof of Power of Attorney.

Radiology and Surgery
If you have an x-ray while in the hospital you will receive a separate bill from Meadville Diagnostic Medical Imaging, Inc. This company is the group of physicians who view and read the x-rays. If you have surgery you will also receive a separate bill from your surgeon and the physician who administers your anesthesia.

Private Rooms
If you request a private room upon admission to the medical center, or if you request a transfer to a private room during your stay, you will be asked to sign our Private Room Authorization form. There will be an additional room charge for each day you stay in the private room. At the time of discharge from the hospital, you will be required to pay in full the charges for the number of days you occupied a private room.

Emergency Department Physicians
If a physician other than your primary care physician examined you in the Emergency Department, you will receive a bill from that physician or designated parties for services performed.  

Patient Financial Services
Customer Service 1-888-219-6117

Revenue Cycle Director 333-5718

Patient Financial Services Supervisor 333-5762  

What preventive services are covered under Medicare Part B?
Bone Mass Measurements - for certain people at high risk for losing bone mass.
Colorectal Cancer Screening tests (such as Fecal Occult Blood Test) - once every 12 months for people with Medicare age 50 and older.
Diabetes Self Management Services - blood glucose monitors, test strips and lancets, and self-management training.
Glaucoma Screening - for high-risk patients, those with a family history of glaucoma, and those with diabetes.
Mammography Screening - once every 12 months for women with Medicare age 40 and over. You are responsible for 20% of the Medicare-approved amount with no Part B deductible.
Medical Nutritional Therapy services - for patients with diabetes or renal disease.
Pap Smear and Pelvic Examination - once every 36 months; once every 12 months if you are high risk for cervical or vaginal cancer for all women with Medicare.
Prostate Cancer Screening - once every 12 months for all men with Medicare age 50 and older. You are responsible for 20% of the Medicare-approved amount for the digital rectal exam after the yearly Part B deductible.
Vaccinations:
Flu Shot - once a year in the fall or winter for all people with Medicare.
Pneumonia Shot - one shot may be all you ever need. Ask your doctor.
Hepatitis B Shot - if you are at medium to high risk for hepatitis. You will be responsible for 20% of the Medicare-approved amount after the yearly Part B deductible.

What services are not paid for by Medicare Part A and Part B in the Original Medicare Plan?
The Original Medicare Plan does NOT cover everything. Your out-of-pocket costs for healthcare will include, but are not limited to:
  
•Acupuncture

•Deductibles, coinsurance or copayments when you get health care services

•Dental care and dentures (in most cases)

•Cosmetic surgery (except after an accident)

•Custodial care at home or in a nursing home

•Hearing aids

•Orthopedic shoes

•Outpatient prescription drugs (with only a few exceptions)

•Routine foot care and orthopedic shoes, except for diabetics

•Routine eye care, glasses, hearing aids

•Routine or yearly physical exams

•Services not reasonable or medically necessary

What is Medicare Part A and Part B?
Medicare Part A helps pay for care in hospitals as an inpatient, skilled nursing facilities, hospice care and some home health care. Most people get Part A automatically when they turn age 65. They do not have to pay a monthly payment called a premium for Part A because they or a spouse paid Medicare taxes while they were working.

Medicare Part B helps pay for doctors' services, outpatient hospital care, and some other medical services that Part A does not cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for those covered services and supplies when they are medically necessary. You pay the Medicare Part B premium of $58.70 per month. In some cases this amount may be higher if you did not choose Part B when you first became eligible at age 65.

Where can I get more information about Medicare?
Questions regarding Medicare Part A - call 1-800-853-1419
Questions regarding Medicare Part B - call 1-800-746-5680
Questions about Medicare Managed Care Plans - call 1-800-633-4227
Questions about Social Security Administration (SSA) - call 1-800-772-1213 or http://www.ssa.gov/
Visit the Medicare Web Site - http://www.medicare.gov/ 

Financial Assistance

Click here for the Financial Assistance Application

MMC offers a Financial Assistance Program for medical care to eligible individuals and families.

The Financial Assistance Program is a part of MMC’s Mission Statement of providing health care services to all patients, regardless of their ability to pay.

Eligibility for Financial Assistance

Patients may be eligible for Financial Assistance if they:

•  Have limited or no health insurance
• Are not eligible for government assistance, such as Medicare or Medicaid
• Can show they have financial need
• Provide the necessary information about household income and resources


Applying for Financial Assistance

MMC encourages patients to apply for financial assistance if they believe that they are unable to pay their MMC bill.

To apply:
•  Complete the Meadville Medical Center Financial Assistance Application form
• Attach supporting documents, listed on the application, to prove your income and resources
• Mail your completed application and necessary documents to:


Meadville Medical Center
CBO Mail Processing Center
1643 Lewis Avenue, Suite 203
Billings, MT  59102


Financial Assistance Policy

The following is a summary of MMC Financial Assistance Policy.  This is a general overview of the policy.  MMC will review each application individually to determine qualification for Financial Assistance.

MMC’s policy is to provide financial assistance for patients who:
•  Have limited or no health insurance
• Have applied for governmental assistance, such as Medicare or Medicaid, but did not qualify
• Demonstrate financial need
• Supply MMC with necessary information about household income and resources


Financial Assistance is available for eligible patient who require:
•  Emergency medical services
• Non-elective services for urgent life-threatening conditions, outside the Emergency Department
• Other medical necessary services, on a case-by-case basis


MMC does not have the authority to waive any charges from physicians or other health professionals who are not employed by MMC

Determination of Eligibility for Financial Assistance

To request financial assistance, patients submit the MMC Financial Assistance Application form, disclosing household income and resources.

Applicants are treated with dignity and respect throughout the process.  All information is handled with confidentiality.  The patient’s cooperation in providing MMC with necessary information is imperative to the process.

Typically, a patient is not eligible for MMC Financial Assistance until he or she has applied for and been deemed ineligible for Federal and Commonwealth of PA governmental assistance programs.  MMC has Financial Counselors available to assist patients in applying for Pennsylvania State Medicaid.

MMC reserves the right to process the Financial Assistance Application without this determination, provided enough information is available to make an accurate assessment of the patient’s financial situation.

Determination of Assistance

In determining a reasonable and fair level of assistance, MMC applies a sliding scale.

If a patient’s income is below 300 percent of the Federal Poverty Guidelines - The patient may receive some form of Financial Assistance.

At or below 200 percent of the Federal Poverty Guidelines:
The patient may be eligible for 100 percent financial assistance after the first $200.00 of billed charges


Between 201 and 300 percent of the Federal Poverty Guidelines:
The patient may be eligible for a 50 percent reduction after the first $200.00 of billed charges


Exclusions

While MMC’s Financial Assistance Program covers most services, there are some exclusions, such as, but not limited to:

• Cosmetic services
• Elective reproductive services
• Services deemed non-covered by Medicare or Medicaid
• Other services, at MMC’s decision


Financial Assistance is not typically available for:

• Insurance co-payments
• Insurance deductibles
• Services lacking insurance requirements, such as obtaining authorizations or referrals
• People who opt out of available insurance coverage




Please click on the link below to apply online for Pennsylvania Medicaid

https://www.compass.state.pa
Copyright 2013 by Meadville Medical Center & Subsidiaries