Thank you for choosing Gritman Medical Center for your healthcare needs.
At Gritman we realize your family’s healthcare experience is not limited to just a visit here, but includes the billing process as well. We are committed to providing you the best care possible and keeping you informed about the charges for services and your obligations.
Our financial team can help you with:
Gritman Medical Center’s fees were developed by competitive market analysis in combination with current Medicare and commercial insurance reimbursement schedules. Our Governing Board reviews and approves the fee schedule affirming that charges reflect our area and are not guided by your insurance company’s arbitrary determination of usual and customary rates.
You have an obligation to pay the charges that are not covered by your insurance carrier. Please verify insurance benefits prior to any procedure and provide us with your current insurance information.
Your insurance company may require you to obtain Prior Authorization for treatment. If so, please obtain written approval before admission to the hospital.
We are contracted with several government agencies. Under their regulations we may not be able to bill them if a third party liability insurance is responsible, including Medicare, Medicaid, Tricare, Veterans Administration, and others.
Health insurance companies require a Third Party Liability Insurance (Automobile Insurance & Homeowners Policy) claim to process before we can send a claim to the government agencies or health insurance companies for reimbursement. If you request that we NOT bill your third party liability insurance you may be held responsible for the charges.
At your request, we will submit a claim to your Primary Medical Insurance Carrier. You may receive an accident questionnaire from your insurance company to be completed by you. If the questionnaire is not returned to your medical insurance company and we receive a denial on your claim, a statement will be sent to you for the denied charges.
We will bill your personal primary automobile insurance for all auto accidents, if information is provided. Your personal auto insurance can make payment on your claim and then your agent may bill the at fault insurance policy to get reimbursement. Our relationship is with you, not your auto insurance company, therefore it is often necessary for you to inquire on your hospital claim with your auto insurance carrier.
You may receive a bill from the hospital even though you were not a patient. If your doctor performed lab work or a biopsy for you in his or her office and sent it to the hospital for analysis, you will receive a bill for this service. You will also receive a bill from your physician for his or her service.
Emergency Services billing is typically done in two parts. One claim form is submitted for the emergency room physician charges and one claim form is submitted for the emergency room hospital charges.
These two claim forms will be sent out to the insurance company but they do not always get processed at the same time. Insurance companies will process these charges and send two separate explanation of benefits to the policy holder.
Gritman Medical Center will receive two separate checks at different times.
When you receive your Gritman Medical Center statement, one set of charges could be processed and paid on by your insurance company. But the other set of charges could still be pending insurance payment. These charges will be under the Insurance Pending column of your billing statement. Once your insurance company processes the pending charges they will show up on your next month billing statement under Patient Responsibility column. If you have questions please contact the Patient Billing Office at (208) 883 2224.
You will receive a monthly statement from us for any remaining balance after your insurance processes your claim. Your payment is expected within 20 days of receipt of this statement.
Alternative arrangements can be made if you are unable to meet your financial obligations. However, you will need to contact the patient billing office to set up the agreement. After 30 days our patient billing office will transfer your accounts to our extended patient billing office First Party Receivables who can be contacted toll free at 877 304-1299 or (208) 883-4596.
As a nonprofit organization, we take seriously our social responsibility to provide access to services regardless of one’s ability to pay. Our Financial Assistance - Charity Care program is designed to help those patients who need financial assistance in covering bills from Gritman Medical Center.
In those situations where appropriate primary payment sources are not available, patients shall be considered for financial assistance - charity care under this policy as calculated for the 12 months prior to the date of request.
The full amount of hospital charges may be determined to be financial assistance - charity care for any patient whose gross family income is at or below 200% of the current federal poverty guidelines as published in the most current Federal Register.
The following sliding fee schedule shall be used to determine the amount which shall be written off for patients with incomes between 201% and 400% of the current federal poverty guidelines.
|Medically Indigent Discount Guidelines|
|Federal Poverty Level (FPL)||Discount|
|0 to 200%||100%|
|201% to 250%||80%|
|251% to 300%||60%|
|301% to 350%||40%|
|351% to 400%||20%|
NOTE: Patients at 200% and below Federal Poverty Level must make a $10 co-payment for each clinic visit (no co-pay is due for services provided at hospital or when the clinic visit is a follow-up from a hospital visit).
Gritman Medical Center may also write off as financial assistance - charity care amounts for patients with family income in excess of 400% of the federal poverty guidelines when circumstances indicate severe financial hardship or personal loss.
Available assets and extraordinary circumstances will be reviewed to assist with eligibility determination for catastrophic charity care. Please contact our Financial Counselor for more information.
Please contact our patient billing office for more information at (208) 883-2224.
If you have more than one account with Gritman Medical Center, you may combine them for payment arrangements after appropriate insurance payments have been received. All accounts must have a current balance and must not have been placed with an agency or have legal action.
Call patient financial services at (208) 883-2224 as soon as possible to provide the following information or fax the information to (208) 883-6580:
Please contact our Financial Counselor for an application. Call (208) 883-2223. Your financial responsibility to Gritman Medical Center will be based on your ability to pay.