Patient Financial Responsibility
We appreciate you choosing St. Mary’s Medical Center. As part of our quality service we feel it is important that you are informed of our payment policies.
How much will it cost?
If you would like to obtain a verbal estimate for a procedure you are having, please call the Price Quote Line at 816-943-3987. Be prepared to leave your name, telephone number, which hospital, and any information you have about the procedure. We will return your call within 24 hours, Monday thru Thursday, and if you call after 5 p.m., on Friday or over the weekend, we will call by the following Monday.
Factors such as insurance deductible, co-insurance, or co-pays may affect your out of pocket responsibility, so please check your insurance benefits.
Insurance Patients: Please verify with your insurance company that you have met your precertification requirements and/or referral requirements prior to services being rendered. Please bring a referral and/or precertification letter with you.
Timely Filing: Many insurance companies require claims to be filed within pre-defined time frames. To enable our Business Office to file a claim on your behalf in a timely manner, please make sure updated insurance information is provided at the time of service. You will be asked to review your face sheet at the time of registration. Please take this opportunity to carefully review all of your personal information your (patient) name, address, guarantor name, and address as well as make sure insurance information is updated and correct. Failure to provide insurance information in a timely manner could result in the bill becoming your responsibility.
Reminder to Insurance Patients: Because your insurance company expects prompt remittance of your premium, you have a right to expect their prompt payment of your claims. Please contact them to ensure payment within 30 days from the billing date (excluding Medicare), and for second insurance, within 20 days from the date the primary insurance pays. Your cooperation will:
- assist the hospital in containing your healthcare costs
- prevent follow-up phone calls to your home or office
If you were unable to provide complete billing information at the time of your visit, please phone the information to the following numbers: Emergency patient, 816-943-2716; inpatient or outpatient,
816-943-2527 within 48 hours.
After 48 hours, please call 816-943-2192.
Be prepared to give patient name, insured name, insurance name, mailing address, policy numbers, group numbers for both primary and secondary insurance plans and pre-cert number.
Auto Accident: Written authorization is requested in order to bill for auto policy benefits. Without this, the medical center will look to the patient for payment in full.
Workers’ Compensation: Phone verification and/or written approval is required to bill an employer for any medical claims.
Parents of Minor Children: Insurance regulations now require the primary insured to be determined by parent with the first birth date of the calendar year.
Minor Children/Guarantor Responsibility: The parent signing the consent for treatment will be the billing guarantor unless written authorization states otherwise.
HMO/PPO Insurance Coverage Authorizations: Most health maintenance and preferred provider organizations require you or your doctor to contact them for treatment authorization. Should they defer your benefits from coverage at St. Joseph Medical Center, we do not deny you care; it means you will be financially responsible for the bill and payment will be necessary at the time of service. Call your insurance agent for information regarding your plan.
Billing from Separate Offices
Cardiovascular Procedures: The Cardiologists who practice in the medical center are required by law to interpret non-invasive cardiovascular procedures and send a report to the referring physician. Therefore, the cardiologist will submit a bill to Physicians Business Network (PBN), P.O. Box 871953, Kansas City, MO 64187-1953, for any professional fees associated with non-invasive procedures. You will receive a statement from PBN. The medical center will show a charge for use of the treatment room and other services provided.
Some cardiovascular procedures that are billed by PBN:
- EKG – Electrocardiogram – Routine $33
- Cardiovascular Stress Test -Routine $80
- ECG Monitor -Routine $162
- Echocardiography – Routine $231
- Doppler Color Flow Mapping
X-ray Charges: The Radiologists (X-ray specialists) who practice in the medical center are required by law to read all X-ray examinations and send a report to the referring physician. Therefore, the Radiologist (St. Joseph Radiology, div. of Alliance Radiology, PO Box 804451, Kansas City, MO 64180, telephone 913-432-3909) will submit a bill to you for their services. The medical center will show a charge for the use of the X-ray room and other services provided.
Emergency Department Physicians: The Emergency Department physicians at St. Joseph Medical Center (Medical Billing Solutions, P.O. Box 414965, Kansas City, MO 64141) will submit a separate bill to you for their services in diagnosing and treatment of a patient’s illness. The medical center will bill for the use of the Emergency Room and services.
P O BOX 804451
Kansas City, MO 64180
Clinical Cardiovascular Associates
P.O. Box 8650
St. Joseph Emergency Physicians
PO Box 2747
Shawnee Mission, KS 66201
Physicians Reference Laboratory
PO Box 7210
Shawnee Mission, KS 66207
Pierre W. Keitges, M.D.
P.O. Box 875865
4911 S. Arrowhead Drive, #201
Independence, MO 64055
Frequently Asked Questions
Why Doesn't My Insurance Pay For This?
Every policy is different and many have limits on what they will cover. You may be required to pay more for a service if you have not yet met your annual deductible, or if the service is not covered by your policy at 100%. Medicare and Medicaid also have limits on what they will pay for hospital and physician services.
What is a Co-Pay?
Most HMOs (Health Maintenance Organizations) and some other forms of insurance require patients to pay a small payment each time they visit a doctor or go to the hospital. This payment can be as little as $15 or may be as high as $50 or more, depending on your specific policy. This co-pay is required each time you visit the doctor or hospital.
What is a Deductible?
Some insurance policies, especially PPO’s (Preferred Provider Organizations) and so-called “traditional” policies, require you and/or your family to pay a minimum amount per year toward your healthcare expenses. This deductible could be as little as $250 per year, or as much as $1,000 or more. You will be required to pay for all of your healthcare expenses until you have met this deductible amount. After you reach the deductible, your insurance company will then pay for most, or sometimes all, of your bill. You only have to meet your deductible once each year.
Be aware that your policy may require both a co-payment and a deductible. In this case, you will be required to continue to pay a co-pay amount even after you have met your deductible.
What is Co-Insurance?
In some instances, an insurance plan may require you to meet your annual deductible as well as to pay Co-insurance even after the deductible is met. Co-insurance is usually based on a percentage of either the provider’s actual charge or provider’s allowed charges. Some insurance plans have a co-insurance that is as little as 10%, while others can be 50% or more.
What Things Are Covered By Insurance?
Typically, most insurance policies will cover hospital and physician charges when you are sick, including lab tests, x-rays and other related tests. Many policies do not cover other services such as medicines, home health, nursing home stays, wheelchairs, non-emergent ER visits, etc. Please check your policy for details or call your insurance company if you have questions.
Will I receive a bill from only the hospital?
No. The hospital will bill you or your insurance for only the technical, or hospital, component of your visit. All physicians (including your ER Physician, Radiologist, Pathologist, Cardiologist, Anesthesiologist, Neurologist, etc ) will bill separately for their professional services. If insurance information is provided at time of service, the companies listed above will bill your insurance on your behalf.
What Things Will I Be Responsible For Paying?
You will be responsible for paying any amount not covered by your insurance policy. This may include a co-payment, some or all of your deductible, co-insurance, and expenses that are not medically necessary or not covered by your insurance policy.
What if I Have No Insurance Coverage?
Please notify our Financial Representatives and we will work with you to develop a reasonable payment plan. In some cases, you may be eligible for charity care coverage.
What is an Insurance Discount Card?
There are companies now selling “discount cards” for hospital and doctor services to patients. These cards often cost as much as $60 per month or more ($720 per year) and promise to provide patients with discounts on their doctor and hospital bills. Unfortunately, many of those discounts are not offered by your local doctor or hospital; often, they are discounts provided by large hospitals or physician groups in other cities, or by chains of health-related businesses (such as pharmacies, etc.). Before you decide to purchase a healthcare discount card, it is best to determine if it offers any benefit to you here in our area. Be sure to ask if your doctor or hospital will honor the card and offer you a discount.
What if I Can't Afford To Pay All of My Bill Right Now?
If you are unable to pay your bill in full upon receipt, you must notify St. Joseph Medical Center’s Business Office so that a reasonable payment plan may be worked out. Most balances must be satisfied within six months of the date or service, or date that insurance paid.
Who Can Receive Charity Care?
Most patients are eligible for charity care at St. Joseph Medical Center if their income falls below 200 percent of the federal poverty level, based on the size of their family. Your financial counselor can help determine if you are eligible for charity care at St. Joseph Medical Center.
Will I Get Calls From Bill Collectors?
If you pay your bill on time and according to the payment plan you work out with St. Joseph Medical Center, your account will not be referred to a Collection Agency. It is very important that you contact the Business Office immediately if you are unable to pay any portion of your bill. In most cases, St. Joseph will work with you to pay what you owe. However, you must be on a formal contract agreement in order to avoid further collection from a collection agency.
How Do I Reach Customer Service?
Customer Service Representatives are available to answer your questions, Monday through Friday, 7 a.m. – 6 p.m.
St. Joseph Medical Center Business Office