Patient Financial Services
Most insurances are accepted.
Because of the numerous provider networks available, please contact your insurance company’s Customer Service or Account Representative to verify your benefit coverage at Prowers Medical Center as well as with your Primary Care Provider.
PAYMENT POLICY FOR UNINSURED PATIENTS
For those without medical insurance, the cost of hospitalization or having a diagnostic test can be a financial challenge. We believe that patients should seek care when medically necessary without fear of related costs. To assist patients without medical insurance, we offer a discount in the following cases:
The total charges for hospital services will be reduced by 40% when payment is received at the time of service or within 30 days of the receipt of your first bill.
The total charges for hospital services will be reduced by 20% when payment is received within 60 days of the receipt of your first bill.
If payment of your bill is a financial hardship, please call our Patient Financial Counselor at 719-336-7137 to find out about financial assistance.
UNDERSTANDING YOUR HOSPITAL BILL
Do you have questions about your hospital bill? We can help. You’ll find answers to some commonly asked questions below. If you have other concerns about billing and/or payments, please do not hesitate to give us a call. Our Customer Service / Patient Representatives are available Monday-Friday, 9:00 am – 4:30 pm or you can email us your questions.
A: Prowers Medical Center accepts payments made by cash, check, money order, or credit card. We accept Visa, MasterCard and Discover.
Payments may be made:
- By Mail: Use the return envelope that came with your billing statement to make a payment by check, money order or credit card.
- In Person: Stop by our Admissions / Registration Department or Business Office to make a payment in person.
- By Phone: Credit card payments can be made by calling 719-336-4343.
A: Patients who find it difficult to pay their bill in full within 30 days should contact our Patient Financial Counselor at 719-336-7137. The medical center has several payment options available.
A: Financial assistance is available for those individuals who are uninsured or underinsured, who are experiencing financial hardship. Eligible patients would be those who have limited financial resources to pay for an individual insurance policy and who do not qualify for Colorado Medicaid. Your inability to pay for care should not prevent you from receiving medically necessary services. To learn more about our Financial Assistance Program, you can call 719-336-7137.
A: Your visit to Prowers Medical Center may result in billing from various service providers. In addition to the hospital bill you may receive separate billings from professional providers who assisted with your care. These professionals may include, but are not limited to:
- Your Attending Physician/Provider
- Ambulance Company
- Emergency Medical Technician
A: Many insurance companies have amounts which the patient must pay. The amount may be for a co-insurance payment, deductible or an out of pocket expense (an expense not covered by your insurance provider). If you have questions about why your insurance did not pay a portion of your claim, you should contact your insurance company directly. You may also receive a bill if your insurance company does not process our claims by their due date or if they deny coverage of your service. If you receive a statement that does not show insurance processing, you should contact your insurance company to determine the reason for delay / denial.
A: Co-payments are due at the time of service. If you are unsure of your co-payment responsibility please contact your insurance plan. If you are an inpatient our financial counselors will obtain the deductible information at the time they check your eligibility. Prowers Medical Center expects co-payment/deductible amounts to be paid at the time of service. Please be prepared to pay your co-payment/deductible when you check in.
A: The specific requirements and responsibility for completing pre-certification or notification depends on several things:
- Contract agreements between the medical center and your insurance company, or
- The requirements as defined by your insurance or employer group plan.
In many cases, the medical center can assist with these requirements if we have a contract with your company.
However, if you have questions about your responsibility for completing these requirements, you should contact your insurance company directly. You may have to pay a higher deductible or coinsurance amount if these steps are not completed.
A: The charge for services included on your bill is based on many factors that vary from hospital to hospital, including the costs of buying medications, surgical equipment and other supplies; powering and maintaining hospital buildings; paying highly trained healthcare workers; and purchasing up-to-date medical technology.
Charges are usually revised on an annual basis. These changes are made at the beginning of our fiscal year, which is January 1st. However, as technology and resource needs change, we may have to update our charges at other times during the fiscal year.
A: Regardless of a hospital’s charges, the government determines how much the hospital is paid for a service for those enrolled in a federal and/or state program like Medicare or Medicaid, and local negotiations determine how much a hospital is paid by those enrolled in commercial health plans. For patients with no insurance, Prowers Medical Center offers a discount off of its charges so uninsured patients can take advantage of similar discounts much like those the hospital offers to health plans.
A: These are documents showing a detailed listing of how your insurance company processed your claim or bill. An EOB or EOP is mailed by your insurance company directly to you.
Prowers Medical Center, a Colorado Health Services District, will not discriminate in providing medically necessary service to the needy, regardless of their ability to pay.
Patients deemed unable to pay will be eligible to receive financial assistance.
Charity is not considered to be a substitute for person responsibility. The patient is ultimately responsible for fulfilling their financial obligation to Prowers Medical Center and is not granted financial assistance until the application has been completed and approve.
Charity/Financial Assistance: The inability to pay for medical services rendered.
Family: Using the Census Bureau definition a group of two or more people who reside together and who are related by birth, marriage, or adoption. As per the Internal Revenue Service rules, if the patient claims someone as a dependent on their income tax return, they may be considered a dependent for purposes of the provision of financial assistance.
Uninsured / Self Pay: The patient has no third party insurance coverage to pay for hospital/clinic services.
Emergency Medical Conditions: A sudden medical condition where the absence of immediate medical attention could result in placing the individual’s health in serious jeopardy or result in serious impairment to bodily functions or serious dysfunction of bodily organs or parts.
Medically Necessary: Services or items reasonable and necessary for the diagnosis or treatment of illness or injury (as defined by Medicare).
Services Eligible Under This Policy: Charity or Financial Assistance refers to healthcare services provided by Prowers Medical Center without charge or at a discount to qualifying patients. The following healthcare services are eligible for charity or financial assistance:
Emergency Room services.
Services for conditions which if not promptly treated, would lead to an adverse change in the health status of the patient.
Non-elective services provided in response to life threatening circumstances in a non-emergency room setting.
Medical necessary services evaluated on a case by case basis at Prowers Medical Center.
Services Not Eligible Under This Policy:
Services not Medically Necessary as determined by medical professionals
Elective surgeries that are not medically necessary
Sex change surgical procedures
Court ordered procedures, such as drug testing
Abortions, except as specified in Sec.25.5-3-106C.R.S.
ELIGIBILITY FOR CHARITY
Charity eligibility will be considered for patients who are uninsured or ineligible for any government health care benefit programs and are unable to pay for their services based upon a determination of financial need.
Prior to any financial assistance being granted Prowers Medical Center will look at other resources of payment such as CICP (Colorado Indigent Program) or Medicaid/CHP+.
Charity Care request may be initiated by the patient, guarantor or responsible person.
Patients will be asked to complete a Charity Care application and provide supporting documentation which may include:
The Charity Care application will be reviewed and approval will be based on the Federal Poverty Level Guidelines (FPG). The patient will be notified of their patient responsibility.
|FPL||CHARITY CARE||AMT TO COLLECT|
|200% TO 250%||10.00%||90.00%|
|150% TO 200%||15.00%||85.00%|
|100% TO 150%||20.00%||80.00%|
|0% TO 100%||25.00%||75.00%|
*Please note that the first tier of the above charity care program is set at the AGB amount.
If unable to pay in full, the patient may contact a Patient Financial Services Representative at Prowers Medical Center to make payment arrangements at 719-336-4343.
PAYMENT PLAN GUIDELINES
A 40% discount is available to patients with no insurance if paid in 30 days.
A 20% discount is available to patients with no insurance if paid in 60 days.
|$0 – $499||3 months to pay off balance|
|$500 – $999||6 months to pay off balance|
|$1,000 – $1,499||12 months to pay off balance|
|$1,500 and greater||18 months to pay off balance|