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Insurance and Managed Care Information
St. John's Mercy accepts a wide variety of insurance coverage and works
with patients to make special payment arrangements, if necessary. This
section of our Web site is designed to help you understand many of St.
John's Mercy's billing procedures and charges.
For specific information about your coverage, please familiarize yourself
with the terms of your health care plan. Many other general questions
will be answered below.
- Pharmaceutical Coverage
- Select topic to find out more
Precertification
Many insurance plans require a patient be pre-certified (approved) before
going to the hospital for procedures or surgery. As part of pre-registration,
our staff will coordinate with your physician to meet the requirements
of your insurance plan. If you have any questions regarding precertification,
contact your insurance company or primary care physician.
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Financial Information
Your bill reflects all of the services you have received during your
stay at St. John's Mercy. Charges fall into two categories: a basic
daily rate, which includes your room, meals, nursing care, housekeeping,
telephone and television, and charges for special services, which include
items ordered by your physicians, such as x-rays or laboratory tests.
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Professional
Charges
You may receive separate bills for certain tests and treatments for
professional services rendered by pathologists, radiologists, cardiologists,
anesthesiologists and other specialists. These physicians, who may be
needed to diagnose and interpret test results, are required by the government
and insurance carriers to bill you separately. Some physician specialists
may not participate in your health plan and you may be responsible for
part or all of their bills. If you have questions about these bills,
please call the specialist's office directly. The telephone number is
printed on the statement.
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Insurance
Claims
Your insurance policy is a contract between you and your insurance company.
As a courtesy, the Medical Center will submit bills to your insurance
company and will assist you in receiving the full benefit of your health
insurance plan. You are asked to assign benefits from the insurance
company directly to the Medical Center to facilitate billing for the
health care services you are receiving.
Please review your health care plan and remember that payment of your
bill is your responsibility. The Medical Center has several payment
options available to assist you. If there is a question about your health
care coverage, a member of the Admitting department will contact you
or a member of your family during your stay to obtain the necessary
information.
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Co-Insurance
Many insurance plans require the patient to pay a portion of the bill
directly to the care provider; this amount is called "Co-Insurance."
Your insurance card, presented upon registration, helps the Medical
Center to work directly with your insurance company to determine the
extent of your coverage and deductible requirements.
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HMOs
and PPOs
Health Maintenance Organizations and Preferred Provider Organizations
may have special requirements, such as a second surgical opinion or
precertification for certain procedures.
It is your responsibility to make sure your plan’s requirements
have been met. If such requirements are not followed, you may be financially
responsible for all or part of the services rendered in the hospital.
Some physician specialists may not participate in your health care plan
and their services may not be fully covered.
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Medicare
Your Medicare card is presented upon registration to verify eligibility
and facilitate processing your Medicare claim. Please note that the
Medicare program specifically excludes payment for certain items and
services, such as cosmetic surgery, some oral surgery procedures, personal
comfort items, hearing evaluations and others. These non-covered charges,
as well as deductibles and co-payments, are your personal responsibility.
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Medicaid
Presenting your Medicaid card upon registration helps us to process
your patient account effectively because the card contains information
for identifying St. John's Mercy as a participant in your healthcare
plan.
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Payment
Options
Patient balances are due within 15 days after you receive your bill.
Here are your options:
- Full payment may be made by cash, Discover, MasterCard or VISA.You may pay your bill online by visiting our secure web site at
http://www.stjohnsmercy.org/billing
- Other arrangements may be made by contacting the financial counselor
or the Patient Accounting department. During your stay, call extension
6852 to reach the financial counselor's office. From home, call 314-364-4200
or 1-800-833-0799. Office hours are Monday through Friday 8:30 a.m. to
Noon and 1 to 4:30 p.m.
Billing
Questions Online
Visit our online billing
center for frequently asked questions, billing policies and other
resources designed to help patients understand and manage the health care
billing process.
If you have a billing question about your hospital visit, please click
here
to contact the billing department.
If you are a patient and you have a billing question about your physician
services, please click here
to contact the physician billing department.
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