Nurse staffing Ratio: In an effort to maintain a safe environment for patient care, anyone can inquire about our staffing levels and core competencies by calling 815-664-1561 to make an appointment with the Vice-President of Nursing. All questions will be answered in accordance with the 2004 Illinois Report Card Act.

About Your Bill

St. Margaret’s Health is committed to providing quality health care and service to all patients. In order to continue in this mission, it is essential that payment be received for services provided.

As a courtesy to our patients and their families, we submit claims to any insurance company according to the guidelines listed in this brochure. To do this efficiently, it is important that insurance information be presented at the time of registration.

You, or the responsible party (sometimes called the “guarantor”), will receive statements showing any balance due.

Patient Responsibilities
Prior Authorization
An increasing number of insurance carriers now require authorization prior to your receiving hospital and/or physician services. Most of these plans require either you as policyholder or your physician to initiate the prior authorization procedure.

If your insurance has such a requirement, please inform your physician, or contact your insurance carrier. Failure to meet your insurance requirements may result in partial or complete denial of insurance benefits. Our registration staff can assist you in this process.

Patient Responsibility
If insurance payment is not received within 45 days of the Patient Accounts Center submitting a complete claim, payment becomes your responsibility.

Insurance Billing Guidelines
Medicare
St. Margaret’s Health is a certified Medicare provider. When supplemental insurance policy information is presented at the time of service, the Patient Accounts Center will submit the claim for deductibles and coinsurance. This supplemental billing can only be completed after Medicare payment has been received and cannot be done unless complete and accurate information is received at the time of service.

While Medicare must be allowed as much time as needed to process a claim, supplemental insurances will have up to 45 days after Medicare pays before the outstanding balance becomes your responsibility.

Medicaid (Public Aid)
Medicaid billings are submitted when complete and
accurate information is received at the time of service. You will be notified of any balance due.

Workers Compensation
Charges for services incurred as a result of a work-
related injury will be treated as a normal insurance claim. Should the claim be disputed, the outstanding balance will be your responsibility.

Other Insurance
We will bill up to two insurance companies if presented with correct insurance information and assignment of benefits at the time of service. All balances not paid after 45 additional days will become your responsibility.

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When The Patient Owes A Balance
We expect you to make a “good faith” effort to pay any balances due St. Margaret’s Health. The Patient
Accounts Center will work with you to establish a
reasonable settlement of all balances that are your
responsibility. An account is considered delinquent when:

• No payment arrangements have been made within 30 days of final insurance payment (or first billing for self-pay accounts).
• Terms of established financing arrangements are not met.

If your account is delinquent, you will receive one final notice and a grace period of 10 days to forward any balance due. Disputed balances will be subject to review by the Patient Accounts Center before further collection efforts are pursued. In those cases where the Patient Accounts Center has exhausted all reasonable efforts to collect the balance due, the account will be referred to a licensed collection agency for follow-up and collection.

Financing Options
We have staff available to assist you in establishing financial arrangements to meet your needs. You may contact the Business Office for assistance with the following programs:

Credit Cards
We will honor VISA, MasterCard, and Discover cards for the payment of accounts. These payments will be accepted either by phone, in person, or by mail.

Hospital Installment Plan
For accounts with a balance of $250 or more, we will accept payment in the form of twelve equal monthly installments. For accounts under $250, we will accept monthly installments with a $20 per month minimum. Payments are available through direct withdrawal from your checking or savings account (auto withdrawal form). If a payment is missed, the remaining balance must be paid in full within thirty days, or it will be considered delinquent.

Loan Program
We have programs with financial institutions to assist those in need of obtaining financing. We will assist you in securing external financing in those instances where payment arrangements are requested beyond 12 months.

Financial Assistance
Consideration for financial assistance is based on your financial status in comparison with the Federal Poverty Guidelines.

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