HOSPITAL BILLS AND INSURANCE

Financial Arrangements

All patients should familiarize themselves with the terms of their insurance coverage.  This will help you understand the hospital's billing procedures and charges.  If there is a question about your insurance coverage or information is needed to process your claims, a member of the Business Office will contact you or a member of your family while you are here.  Your answers are important for maintenance of your medical records and to assure accurate and timely billing.

WMMC Business Office staff is experienced and available to discuss any questions about the financial aspects of your care.  You are encouraged to contact them with your questions or problems.

Business Office Hours:
Monday-Friday, 8:00 a.m. to 5:00 p.m.
(605) 539-1201

If You Have Health Insurance

Please provide the hospital with a copy of your identification card.  WMMC verifies insurance coverage by contacting your employer or your insurance company.  If your insurance company requires pre-admission authorization, please contact them as soon as possible.  It is your responsibility to be sure pre-authorization is started before admission.  Your claim will be processed as soon as your medical records are completed and reviewed by your physician.

If You Are Covered by Medicare or Medicaid

Please provide a copy of your Medicare card to verify eligibility and process your claim.  As a courtesy to our patients, WMMC submits all Medicare and Medicaid insurance and other third party claims.  You should be aware that the Medicare and Medicaid program specifically excludes payment for certain items and services such as cosmetic surgery, some oral medications, personal comfort items, hearing evaluations, and others.  These excluded items are billed to the patient.  Deductibles and co-payments also are the responsibility of the patient.

If You Have No Insurance

A representative from the Business Office will discuss financial arrangements with you.  WMMC Social Services is also available to assist you in applying for Medicaid or other government assistance programs.

Your Hospital Bill

You will receive a detailed statement of your charges approximately 10 days after discharge.  Charges vary depending on services.  You then receive monthly statements advising you on the status of your bill.

As a courtesy, the hospital submits bills to your insurance company and does everything possible to expedite your claim.  You should remember that your policy is a contract between you and your insurance company and you have the final responsibility for payment of your hospital account.

Your bill reflects all of the services you receive during your stay.  Charges fall into two categories: a basic daily rate, which includes your room, meals, nursing care, housekeeping, and telephone; and charges for special services which include items your physician orders for you, such as x-rays or laboratory tests.

If you have certain tests or treatments in the hospital, you may receive bills from physicians you did not see in person.  These bills are for professional services rendered by these doctors in diagnosing and interpreting test results while you were a patient.  Pathologists, radiologists, cardiologists, anesthesiologists and other specialists are required to submit separate bills.  Your own physician will also submit a separate bill to you.  If you have questions about these bills, please call the number printed on the statement you receive from them.