Insurance Companies
Financial Assistance
At RML Specialty Hospital, our first priority is you. We are looking forward to serving you. We understand that you may have some questions and concerns when you are going to be a patient. Below is some useful information you may need for your visit.
About your bill
Hospital bill
You will receive one or more bills for the services you received during your stay at RML Specialty Hospital. Your hospital bill includes charges for your room and board, medical supplies, laboratory testing, pharmaceuticals, radiology services, nursing and therapy care and other medical services as ordered by your physician.
Physician bill
You will receive separate bills from the doctors who provide medical and surgical care to you in the hospital. These physicians include:
- Primary care physicians
- Specialty care physicians
- Radiologists
- Pathologists
Billing Process
If you have provided us with complete and accurate insurance information and an authorized assignment of insurance benefits, RML will file your primary and secondary insurance claims for you.
Most insurance plans do not provide full coverage for hospital billings. You will be expected to pay deductibles, co-payments and coinsurance charges at the time of services or at discharge.
Hospital bills are usually sent to your insurance company within four days of discharge. You will be notified of the balance on your account (minus any previous payments) after your insurance company(s) has paid its portions.
If you do not have health insurance, you could be eligible to receive an uninsured discount off of total charges. For more information prior to your service, you may call 630-286-4516 to talk to the Admitting Manager.
Additional information
Medical bills are often unplanned and can be difficult to understand and/or to pay. RML Patient Financial Services representatives are available to explain your bill, answer billing or insurance questions, arrange payment options, or provide applications for financial assistance concerning your bill.
Phone:
Patient Financial Services (630) 286-4402
Mail:
RML Specialty Hospital
PFS Department
5601 South County Line Road
Hinsdale, IL 60521
Insurance companies
Contracted insurance
If you have health insurance (i.e, PPO, HMO, POS, etc.) please refer to either your benefit plan hand book or your insurance company to familiarize yourself with your available benefits including deductibles, co-insurance, and pre-certification requirements. RML participates with a number of HMO’s, PPO/POS plans. The hospital is currently participating in the following managed care plans:
Blue Cross/Shield of Illinois – all plans
Chandler Group- Preferred Plan
Cigna
Corvel
First Health
Great West Health Care
HFN
Humana HMO/PPO
Multiplan
Paradigm
Personal Care
PHCS
Providers First
Three Rivers PPO
UHC HMO/PPO
Contracts change frequently; always check with your insurance company for the most current information regarding your individual benefits.
RML will submit bills to your insurance company when complete information is supplied. Please remember that your policy is a contract between you and your insurance company, and you have a final responsibility for payment of your hospital bill. RML makes every effort to work directly with your insurance company, on occasion; we may solicit your help in resolving eligibility and payment issues.
Medicare
Because most of our patients are eligible for Medicare, we’ve included the following overview to help you understand the coverage Medicare provides.
2013 Medicare Hospital Coverage
Medicare Part A pays – inpatient hospital’s semiprivate room & board, general nursing and other hospital services and supplies. Medicare gives you 60 regular days and 30 coinsurance days. You are also eligible to elect to use your 60 lifetime reserve days. Lifetime reserve days can only be used one time.
Hospital days you pay:
| Day 1 – 60 (60) | The 1st day as an inpatient to a hospital the beneficiary would be responsible for paying $1184.00 deductible. Medicare pays 100% of eligible charges for the remaining 59 in-patient days. |
| Days 61 – 90 (30) | These are considered co-days, Medicare will pay all but $296.00 each co-insurance day |
| Days 91 – 150 (60) | These are considered Lifetime reserve (LTR) days. Medicare will pay all but $592.00 each LTR day. |
| Days 151 + | Medicare will not pay any services. |
Medicare refers to each hospital admission as a benefit period or spell of illness. You must be out of a hospital or skilled nursing home for 60 consecutive days before your regular and coinsurance days renew back to 60/30, again your LTR days will not renew, only the days not used in a previous hospital/SNF stay will be available for your use on your next hospital visit.
Most beneficiaries purchase Medigap insurance to help cover the deductible and co-payments not covered by Medicare. Depending on which supplemental plan you have purchased, you could have coverage for additional 365 days after Medicare Part A exhaust.
Medicare Part B – covers for most physician services and supplies used for outpatient services. Medicare pays 80% of the Medicare approved amount and you are responsible for 20%.
Medicare Part B monthly premium will be $104.90.
Medicare Part B deductible will be $147.00.
For additional coverage and information, call Medicare toll free at 800-633-4227 (TTY: 877-486-2048) or visit the website at www.medicare.gov.
Medicaid
RML is a participating provider in the State of Illinois Medicaid Program. Medicaid beneficiaries and other interested in Medicaid eligibility should contact their Local Office of Social Services for more information regarding benefits, coverage and managed care options.
FINANCIAL ASSISTANCE PROGRAM OVERVIEW
Please note, if a patient is eligible for either free care or a discount from hospital charges, the charity discount only applies to hospital charges and does not apply to any independent physician services you may receive as a result of your hospitalization at RML. The extension of financial assistance only applies to medically necessary services that can be provided at RML.
APPLICATION PROCESS FOR FINANCIAL ASSISTANCE
To apply for charity care/financial assistance, please contact the Admitting Manager Manager (630) 286-4516, who can assist and guide you through the application process. Your Care Coordinator can also get you in touch with the Admitting manager to discuss the application process. The following steps are required for evaluation and consideration of your charity care application.
- A full review of all of your insurance options including but not limited to employer cobra, Medicare secondary policies, third party liability, and Medicaid assistance. If other insurance options are available, the patient will be required to pursue such options to the fullest extent possible before the next step in the charity application process can precede. RML is a participating provider in the State of Illinois Medicaid program and can help direct patients in completing and submitting Medicaid eligibility applications.
- A review of immediate family (you and your spouse) sources of income, assets, liabilities, and RML payment plans options.
- An RML Application for Uncompensated Medical Services is required to be accurately and completely filled out and signed by either the Patient or Legal Guardian. The application is not considered complete for review and consideration unless the requested financial documentation is also attached to the application.
- All charity applications are subject to the approval from RML Administration and contingent upon both the availability of beds and charity funds.
- All applicants approved for a discount from hospital charges will be expected to comply with agreed upon payment provisions in order for the financial discount to remain in effect.
Signed applications are considered complete when submitted with the following documentation:
- Complete copy of your most recent Federal Income Tax Return and all schedules. Include copies of last year’s W-2 forms.
- Copies of the two most recent, paycheck stubs or a statement from the employer
- Copies of three most recent bank statements (e.g. savings, checking, money market, IRA, 401k, etc.)
- Copies of unemployment, disability compensation benefits statements
- Copies of social security or pension benefits income
- Copy of food stamp allocation
- Copies of government assistance notices, such as Social Security disability and Medicaid
