Billing and Insurance

Questions About My Bill - back to top of page
After receiving a hospital bill, many people have questions about the charges and payment options. If you have questions about your hospital bill, please see our Understanding Your Bill brochure. It contains information about how services you receive at St. Mary’s will be billed as well as payment assistance options available to you.

You are also welcome to contact the St. Mary's Business Office with questions about your bill. The Business Office is open Monday through Friday, 8:00 a.m. to 4:30 p.m. For billing assistance, please call 464-2964. For payment arrangements, call 464-2360.

Billing Information - back to top of page
While you are at St. Mary’s Hospital, your primary focus should be your health. Since the ultimate responsibility for payment of your hospital bill rests with you or your guardian; however, we know you may also be concerned about the financial aspects of your hospitalization.

To ensure your peace of mind, we suggest that prior to your admission, you confirm the type of coverage your insurance policy provides. Please remember that many employers, insurance companies and HMOs/PPOs now require notification by the patient, a family member, or doctor prior to or shortly after admission. If you do not comply with this requirement, your medical benefits could be jeopardized, or your insurance could refuse to pay your bill in part or in full. For your protection, please check with your place of employment or your insurance company for any unique requirements.

After your treatment, a bill will be sent to your insurance company and a summary statement may be sent to you. While your insurance company will probably pay all or some of your bill, you are responsible for paying whatever your insurance company does not cover. Cash, major credit cards, money orders, cashiers checks and personal checks are accepted methods of payment for your portion of the bill. If you would like to set up a short-term payment plan, please call us at 464-2360.

The Hospital cannot enter into long-term financing arrangements for balances due, but we do offer Charity Care for those who are unable to pay their bill.

Medicare - back to top of page
St. Mary's will bill Medicare and, as a courtesy, your supplemental insurance carrier.

Information for our Medicare Patients About the Advance Beneficiary Notice (ABN)
Your doctor may order services to help diagnose a condition you may have or evaluate how well your treatment is working. Your doctor may also order hospital treatment to ensure your good health. Before receiving services ordered by your doctor at St. Mary’s, you may be asked to sign an Advance Beneficiary Notice or an ABN.

An Advance Beneficiary Notice (ABN) is a written notice issued to you by your physician or hospital that tells you why Medicare will probably deny payment for that specific service or item in your case. St. Mary’s or your doctor will provide this notice before you receive hospital services. If you still want to receive the service, you will be asked to sign an agreement that you will pay for the service yourself, if Medicare does not pay.

An Advance Beneficiary Notice issued to you by St. Mary’s will be in writing. It will identify the specific service that may be denied by Medicare and the reason why Medicare may not pay for the specific service.

There are certain services that Medicare does not cover, under any circumstances. These are excluded services. Examples of these services are cosmetic surgery, play therapy, routine or preventive physical check-ups including lab tests that are part of the check-up and most immunizations.

Why does St. Mary’s want me to sign the Advance Beneficiary Notice?
Although Medicare pays for most services ordered by your doctor, Medicare will only pay for services that it determines to be "reasonable and necessary.” When this happens, Medicare rules require hospitals to notify patients when it is expected that Medicare will not pay for hospital services. In these situations, we will ask you, the patient, to sign an Advance Beneficiary Notice agreeing to pay and be billed for these services.

Must I sign the ABN?
No, you have two options: 1) You may sign the ABN and proceed with the test or service. St. Mary’s will request a deposit prior to services being rendered. 2) You may refuse to sign the ABN and choose not to have the service performed. However, in not having the test or service performed, you will be going against the medical advice of your doctor. St. Mary’s advises that you consult with your doctor before choosing this option.

General Insurance - back to top of page
St. Mary's will bill primary and secondary insurance companies when an assignment of benefits is received. Questions concerning specific benefits should be directed to your insurance company.

Accepted Insurance Plan Provider Networks

Charity Care at St. Mary's - back to top of page
Because St. Mary’s continues the mission of its founding Sisters––to serve the needs of the sick and the poor with dignity and respect, compassion and joy––St. Mary’s offers a Charity Care Program that offers financial assistance to all who show financial need. To ensure that the Hospital’s resources are used by those who need them the most, our staff will help you explore all other options for financial assistance. If no alternatives exist and you meet the guidelines for receiving Charity Care, you are welcome to apply for the Charity Care Program.

To Apply for Charity Care
If you wish to apply for Charity Care, please call or visit with a patient accounts representative (464-2964 or 464-2360) to discuss your financial need. We will assist you in completing the Charity Care Application form.

You will be required to furnish proof of income, possibility of future income and information regarding assets. A tax return from the previous year (if applicable) and payroll stubs for the past 90 days must be submitted as proof of income. You must also demonstrate you have made every effort to secure financial aid from existing programs for which you may be eligible, including private insurance or Public Aid. St. Mary’s Director of Financial Services will review the application and supporting documents and determine if you are eligible for St. Mary’s Charity Care.

  St. Mary's Charity Care Application

If You Qualify for Charity Care
If you qualify, you will be notified within 10 days regarding the percentage of your account that will be covered by Charity Care. The Director of Financial Services will subtract that amount from your bill and confirm payment arrangements on any remaining balance. A notation will be placed in your patient file regarding the portion of the bill waived through the Charity Care Program.

If You Do Not Qualify for Charity Care
If you do not qualify for Charity Care, you will be notified of the reasons for your denial. In addition, you will receive an itemized bill for services provided by the hospital. You must make arrangements to pay your account in full. To establish payment arrangements, call 217/464-2360. All accounts not qualifying for Charity Care will be returned to the hospital’s active files for normal follow-up. You are eligible to reapply for Charity Care if your financial situation changes.

For more information about St. Mary’s Charity Care Program or for reconsideration of eligibility, please call 217/464-2964 or 217/464-2360

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