OSF Saint Paul Medical Center

Mendota, Illinois

Billing

If you have questions, or if you need more information, please contact a patient services representative, weekdays 8 a.m to 4:30 p.m.

Hospital Billing or Insurance Questions call (800) 421-5700 or (309) 683-6750

Medical Group Billing call (800) 589-6070 or (309) 683-5990
 

Insurance Plans and Financial Assistance

Insurance Plans and Financial Assistance Applications

Information on Illinois Uninsured Discount (PDF - 129.1 KB)


Affordable Care Act

Pricing Transparency

Policy:  All patients of OSF Saint Paul Medical Center will be afforded the opportunity to obtain a reasonable charge estimate for services provided by this facility.

Purpose:  This policy advises patients of OSF Saint Paul on how to obtain standard charges in compliance with the Affordable Care Act, Section 2718(e) of the Public Health Service Act.

Definitions:

Hospital charges are the amounts set before any discounts.  Hospitals are required by the federal government to utilize uniform charges as the starting point for all bills.

Charges are based on what type of care was provided and can differ from patient to patient for the same service depending on any complications or different treatment provided due to the patient’s health.  Therefore, actual charges for a specific patient will differ from the listed standard charges.

Cost for a hospital, is the total expense incurred to provide the health care.  Hospitals have higher costs to provide care than freestanding or retail providers, even for the same type of service.  This is because a hospital is open 24 hours a day, 7 days a week and needs to have everything necessary available to cover any and all emergencies.  Non-hospital health care providers can choose when to be available and typically would not provide services that would result in losses.

Total Price is the amount actually paid to a hospital.  Hospitals are paid by health plans and/or patients, but the total paid is significantly less than the starting charges.  Medicare and Medicaid pay hospitals according to a set fee schedule depending on the service provided, much less than the hospital charge and actually less than their costs.

Procedure:

Patient Registration and Patient Registration Emergency Department will be provided a current charge listing for all routine and /or common diagnostic testing. (CBC,CMP,X-Ray, CT, MRI)

Patient inquiries for common diagnostics not included on the Patient Registration charge listing will be referred to department managers. If managers are not available, patient registration may notify Patient Financial services counselors to follow-up with patients after they have contacted managers.

Patient inquiries for any complex procedure prices will be referred to Health Information Management (Medical Records) or Chief Financial Officer. Health Information Management (Medical Records) will be available for direct patient contact Monday thru Friday, between the hours of 08:00 AM and 04:30 PM, 815-539-1647. Initial response to charge inquiry messages left, shall be returned within two business days.

Estimates for all complex or surgical procedures shall be based on a current case sampling of similar cases without complications.

The patient shall be advised that the estimate is the current average cost of care for similar services without complications and are an estimate only. The total cost of actual care will be based on actual services provided and may be higher or lower than the estimate provided.

The patient shall be advised that the estimate being provided is for gross hospital charges, prior to his or her insurance carriers’ policy specific benefits having been applied. The patient shall be directed to his or her carrier to obtain anticipated out-of-pocket once policy specific benefits have been applied.

Patients without insurance or that voice financial concern shall be directed to a Financial Counselor who will perform a financial assistance screening for any potential ACA approved payer source in addition to charitable assistance.

Estimates shall be provided in HIPAA compliant written format, at the patient’s request.

Pricing inquiries received by any service location other than Patient Registration shall be referred to Health Information Management (Medical Records). (HIM may forward to department managers if the request is not for a complex procedure.)

Effective Date:  10-1-14