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Patient Billing Information

Thank you for choosing Mid-Valley Hospital for your healthcare needs. Please take a few minutes to review the billing policies of the hospital. We recognize that billing and insurance forms are sometimes difficult to understand. That is why our Financial Counselors in the Business Office of the Hospital are available to personally assist you. If you have any questions or need help with your bill or the forms, please contact a Financial Counselor at (509) 826 1760.

Prior Authorization for Treatment

For payment purposes, many insurance companies require that you get their approval before your treatment begins. If your insurance company does require pre authorization, please obtain written approval before admission. If you are unsure about your need for authorization, please ask your insurance company.

Types of Patients and Billing Information

Inpatient

An Inpatient is a patient who is hospitalized at Mid-Valley Hospital.

Insured Inpatients

We can process the papers that are necessary to submit your insurance claim. As you know, your policy is a contract between you and your insurance company. The Hospital has no control over the provisions, exclusions, coverage or benefits. We will do everything possible to process your claim, but please remember that you are responsible for your account.

After the billing has been submitted, your insurance company has 30 days to provide payment for services.

Uninsured Inpatients

If you do not have insurance, payment of your bill will be due upon discharge unless other arrangements have been made with your Financial Counselor.

Outpatient

A patient who uses the services Of MidValley Hospital, but is not hospitalized, is called an Outpatient.

If you receive services as an Outpatient, we ask for payment at the time of the services unless other arrangements have been made with your Financial Counselor.

Types of Admissions to the Hospital

Pre Admissions

A Financial Counselor will contact you to pre admit you, whenever possible, through the completion of a pre admittance form.

Pre admission will:

• Decrease the normal admission time when you enter the hospital.
• Allow a Financial Counselor to evaluate your financial needs in the event: that you do not have enough insurance coverage.

Elective Admissions

If your insurance does not cover your bill or only covers part of the bill, we will need an advance deposit of one half the balance due. This deposit needs to be made before 4 pm the day prior to admission.

We can provide estimates for elective surgeries, but the patients individual needs will decide the actual costs. For any estimates, please contact your Financial Counselor.

Emergency Admissions

Mid-Valley Hospital will provide emergency treatment to all patients regardless of their ability to pay. If you are claiming no insurance or less than total coverage, you will need to meet with your Financial Counselor prior to discharge to find other methods of payment.

Types of Coverage for In Patients and Out Patients

Please identify your type of coverage and provide your Financial Counselor with the information listed. We will send your Hospital bill to the company or agency that provides your coverage. You will be responsible for any portion of the bill that is not covered.

DSHS State of Washington

Present your coupon the day of your visit for the month that you are receiving services. Bring in all of your insurance information even if you have coupons.

Medicare Patients

Present your Medicare Card when you register at the Hospital. Medicare will require that you pay a portion of the bill. Bring in all other insurance information.

Preferred Provider Insurance Contracts

Bring your insurance identification card to the Hospital.

Champus

Present your current Champus Card.

Workers Compensation

Bring your claim form from your employer which will include:

• Employers Name
• Employers Address
• Workers Compensation Carrier Address
• Workers Compensation Claim Number

Indian Health Service

For Inpatient Services or services over $2000.00, you are required to apply for Public Assistance to cover your bill.

If you are qualified for Public Assistance, the Indian Health Service may pay the deductible (balance due).

You can get applications at the Hospital and your Financial Counselor can help you fill out the forms.

Government Funded Projects

You must have written authorization from the program that covers the service you need.

Other Insurances Requiring that You Submit the Claims

We will mail you a detailed list of the services you received from Mid Valley Hospital upon request.

Send this information with the claim form that you submit to your insurance company.

We allow 30 days after billing for your insurance company to provide payment for services to the Hospital.

No Insurance or not Fully Covered

If you are not covered by Hospital insurance, or if you have insurance that covers only part of your Hospital bill, you can make arrangements with your Financial Counselor to use our Time Payment Plan as described below:

ACCOUNT BALANCE LESS THAN	YOUR MONTHLY PAYMENT IS
$ 100.00	$ 25.00
200.00	30.00
300.00	35.00
400.00	40.00
500.00	45.00
600.00	50.00
700.00	60.00
800.00	67.00
900.00	75.00
1000.00	83.50

If the amount owed is more than $1,000, you will need to contact your Financial Counselor to make payment arrangements. Missed or late payments will require payment in full and will void any prior contract arrangements.

Criteria for Charity Care

Mid Valley Hospital assumes its share of responsibility in meeting the needs of medically indigent patients those with no or not enough financial resources to pay for needed care. Charity Care is only available after other financial resources have been used. Charity Care will be granted, regardless of race, color, sex, religion, age, marital status, national origin, or the presence of any sensory, mental or physical handicap, provided the patient meets the eligibility criteria. Please contact your Financial Counselor for an application.

Your Billing Statement

The Hospital will bill for Inpatient and Outpatient Services.

Services Billed Seperately

If you receive any of the services listed below, you will be billed separately by the provider of those services:

• Surgeon
• Primary Care Physician
• Consultant
• Anesthesiologist
• Reading of X Rays
• Pathologist
• Emergency Doctor

The above services are separate and may not be included on your billing statement from the Hospital.

Delinquent (Past Due) Account

Patients accounts become delinquent 30 days after billing or insurance denial. Patients will receive a Final Notice requiring the account be brought current within ten (10) days or paid in full. If the delinquency is not corrected within the ten (10) day period, the account will be considered for referral to an outside agency for collection.

We are Here to Assist You

Please let us know how we can assist you in making the billing process as easy as possible. We are here to answer your questions and help you throughout the payment process. Contact our Financial Counselors in the Business Office of Mid Valley Hospital at (509) 826 1760.