MedWest Patient Financial Services
MedWest Harris
MedWest Haywood
MedWest Swain
MedWest Franklin
MedWest strives for excellence from quality patient care to quality business operations. The Patient Accounting Offices are committed to the financial well-being of our patients and will gladly work with the patient, responsible party or designated representative to assist with insurance benefits and financial arrangements. Each time an individual is a patient at a MedWest facility a new patient encounter or invoice number is assigned. This enables the insurance company to distinguish different episodes of care and allow the insurance company to pay accurate benefits.
MedWest files insurance claims as a courtesy on the patient’s behalf. MedWest accepts assignments of benefits when accurate and complete insurance information is received.
Charge Estimates
Patients and responsible persons may receive charge estimates for services. Please remember this is an estimate only. Final charges are based on physician orders and total services performed.
Harris, Swain, and Franklin:
(828) 586-7755
Haywood
(828) 452-8184
Precertification
Many insurance companies require precertification or prior authorization before a scheduled hospital stay or before outpatient procedures and testing. Registration and Care Coordination staffs makes attempts on your behalf to provide information requested by your insurance company including working with the Physician to obtain necessary precertification. Although we assist in gathering this information, we cannot guarantee approval from your insurance carrier. Ultimately the patient or policyholder is responsible for notifying the insurance company in advance.
Insurance Information
Please present a current insurance card when registering and checking in for services.
The information on the card is important identification of insurance benefits and patient privacy. It is important that we receive your insurance information quickly. Your insurance company may have a timely filing deadline that must be met in order for your benefits to be paid. Balance penalties could result in patients paying higher out of pocket amounts without accurate and timely information. There may be some services that insurance will not cover. The patient or guarantor is responsible for payment of non covered services. Deductible, coinsurance and patient estimated portions are due at the time of service.
Pre-Registration
When you schedule a service at any of the MedWest sites you may be contacted by one of our Pre-Registration staff to obtain your demographic and insurance information prior to your visit. Providing this information in advance will save you time the day of your service. The Pre-Registrar will take time to explain your insurance coverage and any deductibles or coinsurance that may be due from you.
You may also pre-register for services at any of the MedWest hospitals via the internet at
www.medwesthealth.org and click on Patient Pre-registration.
Commercial and Managed Care Insurance
MedWest will submit claims to any insurance carrier for which we have received complete and accurate information and when benefits are assigned to MedWest. In some cases your insurance plan may not be in network with MedWest. In that case responsible parties may experience a higher bill. Please call your insurance company to be made aware if this could be an issue for you.
Medicare
MedWest will submit Medicare claims for patients. Patients are responsible for deductibles, coinsurance and amounts for non-covered services.
Medicare Part A – covers inpatient hospitalization services
Medicare Part B – covers outpatient hospital services, medical and physician services
Medicare Part C otherwise known as Medicare replacement or Medicare Advantage Plans – covers various healthcare services based on your benefits and is considered
Medicare Managed Care
Medicare Part D – covers retail pharmacy items and are billable by MedWest for pharmacy services provided only at Hospital Hill Pharmacy in Sylva, NC
MedWest Patient Financial Services Departments submits insurance claims for Medicare supplemental policies when complete information has been provided.
Medicaid
MedWest will submit claims to Medicaid if you have presented a current valid card or verification of coverage has been obtained through the Department of Social Services. You may be responsible for a portion of the charges of Medicaid determines a co-payment or deductible is due.
Worker’s Compensation
If you are hurt as a result of injury on the job, MedWest will bill your employer or your employer’s workers compensation carrier. In cases where Worker’s Compensation denies the claim or services receive include work-related as well as non-work related healthcare services, your health insurance information will be needed. If there is no other health insurance coverage the patient will be responsible for payment of services.
Other Providers and Bills
The responsible party may receive additional bill(s) from physicians that provided care.
Those bills may include radiologist interpretation fees, anesthesiologist fees for administration of anesthesia during a procedure or pathologist fees for interpreting laboratory results. The responsible party should work with these individual offices for payment.
Asheville Anesthesia
828-274-3477
Asheville Cardiology
828-586-7451
Carolina West Radiology
828-586-7120
Haywood Emergency Medical Services
828-454-0478 or 800-814-5339
Haywood Medical Imaging
828-452-8151
Mountain Pathology
800-528-3448
Prime Doc Hospitalists for inpatients
800-815-7491 x239
Sylva Anesthesiology
800-221-5630
TeamHealth Emergency Room Physicians
888-952-6772
MedWest’s Physician Practices
828-631-8206
Central Billing Office
Blue Mountain Urology
Carolina Mountain Medical
Center for Family Medicine
Harris Emergency Medical Services
Haywood Medical Associates
Haywood Surgical Associates
Haywood Women’s Center
Mountain Medical Associates
Swain Medical Center
Sylva Medical Center
Sylva Orthopedics
Sylva Women’s Center
Waynesville Family Practice
Western Carolina Cardiology
Western Carolina Pulmonary
WNC Hospitalists
WNC Pediatrics
Co-Pays, Deductibles and Patient Balances
Patients with commercial or managed care coverage are responsible for paying co-pays, deductibles and fees for non covered services at the time of medical service. Please review your insurance policy benefits. If you have questions about your coverage, contact your employer or insurance company.
Payment Options and Discounts
Payment is accepted with cash, personal check or money order, bank cards, VISA, Mastercard and Discover. Responsible parties are eligible to receive a 20% prompt payment discount if the account is paid in full prior to or at time of services. A 15% discount will be allowed if payment is made in full within 25 days of the date of service. After 25 days past the service date discounts no longer apply. The patient or guarantor is responsible for payment of non covered services. Deductible, coinsurance and patient estimated portions are due at the time of service.
MedWest accepts:
•
Cash
•
Personal check or check card
•
90 days same as cash
•
Credit cards; Visa, Mastercard, Discover
•
Payment arrangements; contact Customer Service
•
Medicaid eligibility
•
Financial assistance for patient who meet Federal Poverty Guidelines through the Care Assistance Program (CAP)
Billing Statements
Patient summary statements will be mailed after services are received, normally within 10 days. If insurance information has not been provided please contact the Patient Accounts office.
A service confirmation letter will be mailed identifying the insurance on record.
If the insurance information has changed please contact the Patient Accounts Office.
MedWest Harris/Swain/Franklin
Harris/Franklin:
(828) 631-9644
Swain:
(828) 488-1044.
MedWest Haywood
(828)-452-4624
Any Facility Toll Free:
(866)-213-7755
After insurance has processed the claim the responsible party will receive a bill for balance due. Some patients are unable to pay balances in full and need an extended time to pay for services. MedWest requests responsible parties pay in full within 90 days of the balance due statement. This allows us to remain a viable community healthcare partner.
Sending partial payments to MedWest does not establish a payment plan. If longer payment terms are needed please call our office to establish a formal payment plan.
MedWest Patient Financial Services will follow-up with responsible parties to ensure all questions are answered and payments are received timely.
MedWest refers accounts for external collection processes including legal avenues if the account remains unpaid.
Financial Assistance
Financial Counselors are on staff to assist with potential eligibility for North Carolina Medicaid and our Care Assistance Program (CAP).
MedWest recognizes that healthcare is expensive and often unexpected. Financial Counselors are on staff to assist with potential eligibility for North Carolina Medicaid, other state and federally funded healthcare programs and the Care Assistance Program (CAP).
For potential Medicaid eligibility please contact:
MedWest Harris and Franklin
828-586-7411
MedWest Haywood
828-452-8101
MedWest Swain
828-488-4020
Care Assistance Program
MedWest has developed the Care Assistance Program (CAP) for patients who are financially unable to pay for medical services. MedWest utilizes the federal poverty guidelines to determine financial assistance based on family size and income. Eligibility for CAP will be considered for those individuals who are uninsured, underinsured, ineligible for any government health care benefit program, and who are unable to pay for their care based upon a determination of financial need in accordance with this policy. The granting of CAP shall be based on an individualized determination of financial need and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation. MedWest shall determine whether or not patients are eligible to receive CAP assistance for deductibles, co-insurance or co-payment responsibilities.
Patients without insurance will be responsible for the following co-payment amounts based on the type of service received.
Patients whose family income is at or below 150% of the Federal Poverty Guidelines shall be responsible for the following co-payment amounts per visit.
Co-payment amounts due at time of service:
A. Inpatient
B. Outpatient
C. Urgent Care
D. Emergency Department
E. Rehabilitation services
F. Physician Office services |
$ 10.00
$ 10.00
$ 10.00
$ 20.00
$ 5.00
$ 10.00 |
MedWest reserves the right to reverse CAP adjustments if the information is determined to be false and/or determined that the patient/guarantor has received compensation from sources not identified in the determination process.
In order to apply for CAP a financial statement and supporting documents are required.
For MedWest Harris/Swain/Franklin: 828-586-7186
For MedWest Physicians: 828-631-8213
For MedWest Haywood: 828-452-8192
Credit and Collection Practices
Insurance claims are submitted within days of service to Medicare, Medicaid, Commercial, Managed Care, Liability and all other carriers. Patients are expected to pay any known co-payments, deductibles and non-covered amounts when services are received. All requests for payment are based upon ESTIMATED amounts and are not considered final billing totals. Any remaining balances due will be billed to you once your insurance company has paid or denied. Balances are due and payable upon receipt of your statement. Insurance claims are submitted as a courtesy and do not relieve patients of financial obligations.
If a patient’s account (s) becomes past due, MedWest may pursue outside collection activity including legal action if necessary.
Itemized or summary statements are available to you upon request.
For more information call us and let us help.
MedWest Harris/Swain/Franklin
Harris/Franklin:
(828) 631-9644
Swain:
(828) 488-1044.
MedWest Haywood
(828)-452-4624
Any Facility Toll Free:
(866)-213-7755