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Billing & Insurance

After being discharged, it will take a few days for our staff to finalize your account. We will bill your insurance once we have finalized your charges and coded your diagnoses and medical record. You will also receive a statement of the charges that were submitted to your insurance. Once the insurance pays, you will receive another bill that shows the remaining balance if there is one.

Cashier’s Office

Located on the first floor, the Cashier’s Office will assist you with any questions concerning your charges, insurance payments, payment arrangements and any general questions about the billing process. For more information please call the Cashier’s Office at (870) 541-7984.

Estimate Your Cost/Pricing Transparency

Jefferson Regional is committed to helping its patients, in partnership with their care team, make informed decisions about their medical care. This includes helping patients understand the potential costs of their medical care, along with available financial assistance.

Beginning January 1, 2021, the Centers for Medicare & Medicaid Services (CMS) requires all hospitals to make available a list of their standard charges via the internet in a machine readable format and requires that hospitals publish 300 shoppable services. For more information on cost estimation and pricing transparency,  CLICK HERE.

If you have any questions about JRMC’s standard charges, please contact one of our financial counselors at (870) 541-7990.

Transparency in Coverage

The federal Transparency in Coverage final rule, jointly issued in October 2020 by the Department of Health and Human Services (HHS), the Department of Labor and the Department of the Treasury, contains many requirements that have implications for health insurers, health plans, healthcare providers and consumers.

One provision in the Transparency of Cost Rule requires nongrandfathered group health plans and health insurance issuers in the individual and group health markets to disclose certain pricing information in publicly available machine-readable files posted to a website. For more information for BlueAdvantage Administrators, CLICK HERE.

Health Insurance Marketplace

Many Arkansans who have never had medical insurance are now being covered through the Health Insurance Marketplace. JRMC has informational materials that explain the new program and how to enroll. Pick up a brochure at the information desk in JRMC’s main lobby, or go to our marketplace page.

If you currently do not have health insurance and would like assistance in applying for Medicaid or other potential third-party payment sources, please contact one of our financial counselors at (870) 541-7990, or go to JRMC Financial Assistance.

Office Hours: Monday – Friday, 8:00 a.m. – 4:30 p.m.
Billing Office Telephone: (870) 541-7963

 

 

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 copayments, 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 copayment, 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 providersmay 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 innetwork facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, 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 out-of-network care. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have these protections:

  • You’re only responsible for paying your share of the cost (like the copayments, 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:

o Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).

o Cover emergency services by out-of-network providers.

o 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.

o Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, contact Jefferson Regional Compliance Department at 1-870-541-7395. The federal phone number for information and complaints is: 1-800-985-3059.

Visit www.cms.gov/nosurprises/consumers  for more information about your rights under federal law.

 

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