Patient Billing
Windom Area Health understands that receiving medical care at a hospital can be a time of anxiety and concern for you and your loved ones. It is our goal to simplify the billing process so that you have one less thing to worry about. Please select one of the brochures listed below for more information on our billing practices.
Depending on your health insurance, this hospital-based clinic may charge a separate facility fee, which may result in a higher out-of-pocket expense. For more information, please contact our Billing Department at 507-831-0616.
Surprise Billing
Your rights and protections against surprise medical bills
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s co-payments, coinsurance and/or deductible.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a co-payment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as co-payments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
In addition to federal law, Minnesota law provides Minnesota residents with similar rights and protections against surprise medical bills for emergency services and unauthorized provider services provided by out-of-network health care providers.
When balance billing isn’t allowed, you also have the following protections:
- You’re only responsible for paying your share of the cost (like the co-payments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
- Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact the Department of Health & Human Services at 1-800-985-3059. Visit www.cms.gov/nosurprises for more information about your rights under federal law. You may also contact the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602 for more information about your rights under Minnesota law.
Payment Policies
Many insurance and employer health plans require that certain hospital procedures be pre-certified. Pre-certification requires the plan member to telephone the pre-certification group prior to hospital admission date, condition or illness cause, attending physician and expected length of stay. Emergency admissions generally allow a 24-hour grace period. Most plan identification cards list a toll-free number to call.
Failure to pre-certify may result in substantial reduction in your benefits. Please check your plan card and booklet or contact your claims administrator. Patients will assume financial responsibility if your insurance company is not contacted.
Charges will vary depending on the services provided. You will receive a statement from the billing department advising you of the status of your account. Our charges are for hospital rendered services and those provided by the ER doctors and anesthetists. You will be billed separately by the physicians who administered your care, including any outreach physicians.
As a courtesy to our patients, we will bill your insurance if all the information provided to us is correct. We will need to review your insurance card(s) at every visit to verify our records. Since your insurance policy is a contract between you and your insurance company, you are ultimately responsible for your bill.
Some insurance companies require authorization for specific procedures performed in an outpatient setting. It is the responsibility of the patient/responsible party to know their insurance policy and call for authorization, or the claim will be processed at a low benefit level.
Windom Area Health will submit your hospital claims to Medicare. Please bring your insurance card(s) to the hospital at every visit so we can verify our records. For your convenience, the appropriate hospital claims will also be sent to your Medicare supplemental insurance.
Medicaid/UCare/Blue Plus requires that you provide the hospital with a current copy of your Medicaid/UCare/Blue Plus Eligibility Card. We will submit claims to Medicaid/UCare/Blue Plus and you will be notified of any non-covered services copays and/or spend down amounts for which you are financially responsible.
Hospital services incurred resulting from a worker's compensation injury must be reported to your employer and your employer must complete a First Report of Injury.
Even though there may be a claim against another person or company, it is your responsibility to notify the appropriate person or business of your possible liability claim with them. You may have given your health insurance information at the time you requested services. However, we cannot file this claim to your health insurance carrier without a payment or denial from the responsible third party or insurance carrier. Medicare recipients must exhaust all other payment options before Medicare will accept responsibility for any bills. Medicare also requires providers to notify them of the liability claim, even if no charges are due to Medicare. You are responsible to ensure that Windom Area Health is paid regardless of pending, disputed or litigated claims.
Financial Assistance
Let us help you keep medical bills from becoming a concern.
Windom Area Health offers an internal program that may offer financial assistance ranging from a reduction in the amount of your outstanding balance, up to complete forgiveness of a balance to patients that are experiencing a qualifying financial need.
This program is not affiliated with other Minnesota county or state financial assistance programs.
For additional information or to request an application for Windom Area Health's internal financial assistance program, contact Kim Armstrong, Patient Financial Counselor, at 507-831-0615. She is available Monday through Friday from 8:00 a.m. to 4:30 p.m.
Permítanos ayudarlo a evitar que sus facturas médicas se vuelvan una preocupación.
Windom Area Health ofrece un programa interno que puede brindar asistencia financiera, desde una reducción del monto de su saldo pendiente, hasta una condonación completa del saldo a pacientes que experimenten una necesidad financiera que cumpla los requisitos.
Este programa no está afiliado a otros programas de asistencia financiera de Minnesota, sea estatal o de condado.
Para obtener información adicional o pedir una solicitud del programa de asistencia financiera interna de Windom Area Health, comuníquese con Kim Armstrong, Asesor Financiero de Pacientes: 507-831-0615. Disponible de lunes a viernes │ 8:00 a.m. to 4:30 p.m.
Patients receiving medical care at Windom Area Health (WAH) can apply for financial assistance. The policy is targeted at low-income, uninsured and underinsured patients who meet certain eligibility requirements. Eligibility for full or partial financial assistance is based on completing a financial assistance application and providing the following documentation to demonstrate financial need:
- Two pay stubs and your last filed taxes to show income. The most recent federal poverty guidelines will be used as an income guideline.
- Copies of two months of checking, savings, and investments statements.
- Other income including rental income, pension, annuities, etc.
- If applicable, unemployment notice or child support or alimony amounts.
- In uninsured, provide a copy of your Medicaid denial letter or a letter of explanation of why the patient does not qualify.
Your application will be delayed or denied if the required documents are not provided. If you can’t provide the document(s), please provide a letter of explanation.
The Financial Assistance policies and application can we found on our website at https://windomareahealth.org/patients-visitors/billing/. WAH provides assistance in completing the financial assistance application. Patients may call 507-831-0616 or may present to the front desk at WAH. Confidentiality of financial assistance applications will be maintained.
WAH staff will screen patients for insurance coverage and financial assistance. Staff will provide the patient with contact information for available MNsure-certified navigators who can assist with researching insurance options. A patient may decline to participate in the assistance offered under the financial assistance policies.
MN residents whose annual household income is less than $125,000 will receive the uninsured discount on emergency or medically necessary care or services. This discount percentage is the lowest amount WAH would be reimbursed from a nongovernmental third-party payor.
Completed applications can be turned in at the front desk at WAH or can be mailed to the Patient Financial Counselor at PO Box 339, Windom, MN 56101.
When a financial assistance application that is deemed “complete,” WAH will suspend all collection activity until a decision is made. The patient will be notified of the approval or denial of the financial assistance application by mail within 30 days of the decision. Financial assistance eligibility can be extended up to six months from the approved date.
If a patient applies for financial assistance after an unpaid account has been referred to an external collection agency, WAH will refrain from extraordinary collection actions while the application remains incomplete.
Los pacientes que reciben atención médica en Windom Area Health (WAH) pueden solicitar asistencia financiera. La política está dirigida a pacientes de bajos ingresos, sin seguro o con un seguro insuficiente que cumplan ciertos requisitos de elegibilidad. La elegibilidad para recibir asistencia financiera completa o parcial se basa en la compleción de una solicitud de asistencia financiera y en brindar la siguiente documentación para demostrar necesidad financiera:
- Dos boletas de pago y su última declaración de impuestos presentada que indique sus ingresos. Se usarán las guías federales de pobreza más recientes como pauta de ingresos.
- Copias de los dos últimos estados de cuentas corrientes, de ahorros e inversión.
- Otros ingresos, incluidos ingresos por alquiler, jubilación, anualidades, etc.
- Si corresponde, aviso de desempleo o montos de manutención infantil o pensión alimenticia.
- Si no tiene seguro, presente una copia de su carta de denegación de Medicaid o una carta que explique por qué el paciente no califica.
Su solicitud se retrasará o denegará si no presenta alguno de los documentos requeridos. Si no puede proporcionar los documentos, por favor, presente una carta explicativa.
Puede encontrar las políticas y la solicitud de asistencia financiera en nuestro sitio web en https://windomareahealth.org/patients-visitors/billing/. WAH brinda asistencia para completar la solicitud de asistencia financiera. Los pacientes pueden llamar al 507-831-0616 o presentarse en el módulo de recepción en WAH. Se mantendrá la confidencialidad de las solicitudes de asistencia financiera.
El personal de WAH evaluará a los pacientes en cuanto a cobertura de seguro y asistencia financiera. El personal le brindará al paciente información de contacto de navegadores certificados por MNsure que pueden ayudarlos a buscar opciones de seguro. Un paciente puede rechazar participar en la asistencia ofrecida bajo las políticas de asistencia financiera.
Los residentes de MN cuyo ingreso familiar anual sea menos de $125,000 recibirán el descuento de no asegurados en atención, así como en servicios de emergencia o médicamente necesarios. Este porcentaje de descuento es el monto más bajo que WAH recibiría como reembolso por parte de un pagador externo no gubernamental.
Las solicitudes completadas se pueden entregar en el módulo de recepción de WAH o pueden enviarse por correo postal al asesor financiero de pacientes a PO Box 339, Windom, MN 56101.
Cuando una solicitud de asistencia financiera se considere “completa”, WAH suspenderá toda actividad de cobranza hasta que se haya tomado una decisión. Se notificará al paciente sobre la aprobación o denegación de la solicitud de asistencia financiera por correo postal dentro de los 30 días de tomada la decisión. La elegibilidad para recibir asistencia financiera puede extenderse hasta seis meses desde la fecha de aprobación.
Our Patient Financial Counselor is happy to assist in filling out the financial assistance application. Appointments are encouraged.
English and Spanish applications are available. Interpreter services are offered so our Patient Financial Counselor is accessible to all in our community.
Factors affecting eligibility for Windom Area Health Financial Assistance:
- Income
- Two pay stubs and last filed taxes required
- Evaluation of savings, checking, and investment assets
- Two months of statements required
- Evaluation of monthly expenses
- Any special circumstances you would like the committee to consider
Nuestro asesor financiero de pacientes se complace en ayudar a llenar la solicitud de asistencia financiera. Se alienta a que programe una cita.
Hay solicitudes disponibles en inglés y en español. Se ofrecen servicios de interpretación de tal forma que nuestro asesor financiero de pacientes sea accesible para todos en nuestra comunidad.
Factores que afectan la elegibilidad para recibir asistencia financiera de Windom Area Health:
- Ingresos
- Se requieren dos boletas de pago y la última declaración de impuestos presentada
- Evaluación de ahorros, cuenta corriente y activos de inversión
- Se requieren estados de cuentas de dos meses
- Evaluación de gastos mensuales
- Cualquier circunstancia especial que le gustaría que el comité tome en cuenta
Descargar Solicitud de Asistencia Financiera - Español (PDF)
Haga clic en los enlaces para descargar:
Payment Options:
- Cash, checks and money orders are accepted.
- Visa, MasterCard, Discover and American Express are accepted. For your convenience and protection, you may pay by credit card as follows:
- Call our office at (507) 831-0616 or 1-800-720-1501
- Visit us online at: www.windomareahealth.org or www.mysanfordchart.org
- To protect your credit card information, we no longer suggest sending credit card payments via mail.
- Payment Plans: Our Patient Account Representatives must ensure that financial arrangements are equitable with the hospital's payment policies and we may ask for specific information relative to your current financial situation in order to better determine payment arrangements based on your ability to pay. Windom Area Health is a municipally owned hospital, dependent upon your prompt payment for services rendered.
Prompt Pay Discount
You may be eligible for a prompt pay discount when the balance is paid in full within 30 days of your statement. To receive the Prompt Pay Discount you must contact the Business Office at: 507-831-0616 or 800-720-1501.
Eligibility Services
We are offering an Eligibility Service that has a no cost for patients through MedData. Through this program, we can help you understand how your medical bills can be paid by another source, complete any applications, gather necessary paperwork, set up appointments with state caseworkers and make sure that your case is worked aggressively on until it is approved and paid.
It is a way to assist with getting the benefits you need to help pay for your medical bills.
Click below to learn more about the services. Contact the Windom Area Health Billing Department at 507-831-0616 or 1-800-720-1501 for more information.
Quality Improvement
If Medicare is paying your health care bills and you believe you are being discharged prematurely, you have concerns about your care, or you would like a review of coverage decisions, you may contact:
Minnesota Quality Improvement Organization:
Livanta LLC
BFCC-QIO Program
10820 Guilford Road, Suite 202
Annapolis Junction, MD 20701-1105
Telephone: 1-888-524-9900
TTY: 1-888-985-8775