Medical need and care come first at CHI Mercy Health. CHI Mercy Health will provide medically necessary health care services to all persons who are in need, regardless of age, race, religion, national origin, gender, handicap, sexual orientation or ability to pay. You may have concerns regarding the billing and payment options for your health care visit.
Insurance/Payment Information
The business office must have all necessary insurance and financial information. You are asked to provide:
- Name and address of your insurance company
- Policy number and/or group number
- Social Security number of policy holder
Patients are responsible for any deductible and any amount not covered by insurance. Cash, check, Visa, Mastercard or Discover will be accepted for payment.
Financial Assistance for Patients
CommonSpirit Health understands that paying for emergency and/or medically necessary medical care can be difficult, particularly for patients who lack health insurance. As part of our ongoing commitment to our patients, CommonSpirit works hard to help our patients address their financial responsibilities in a way that is fair and sensitive to their circumstances. We have instituted a program designed specifically to help those who find themselves in financial distress.
The Program
The CommonSpirit Health Financial Assistance Policy (available in multiple languages) applies to uninsured/underinsured patients who come to our facilities for treatment. This policy provides financial relief to patients who qualify based on a comparison of their financial resources and/or income to Federal Poverty Guidelines. The program is designed specifically for emergency and/or medically necessary care patients whose household financial resources and/or income are at or below 400 percent of the Federal Poverty Level.
To qualify for any assistance, uninsured/underinsured patients will be asked to complete a Financial Assistance Application (available in multiple languages) which includes information relating to household income and expenses. If you qualify for partial support from CommonSpirit Health, learn the amounts generally billed/reimbursed for services at CommonSpirit Health hospitals, here:
We are committed to working with our patients to establish an appropriate payment plan based on the amount due and the patient’s financial status.
To review the Financial Assistance Policy, the Financial Assistance Plain Language Summary Policy, and the Financial Assistance Application, click here.
If you have questions regarding our policy or applications(s), please contact:
Financial Assistance Center
P.O. Box 660872
Dallas, TX 75266-0872
1-844-286-5546
CHIFA@coniferhealth.com
No Surprises Act
The No Surprises Act protects consumers who get coverage through their employer (including a federal, state, or local government), through the Health Insurance Marketplace® or directly through an individual health plan – click here for more information
Online Bill Pay
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Understanding your bill
Inpatient hospital room charges begin on the day you are admitted and continue each day with the exception of the day you are discharged. The room charge includes nursing care, meals, and cost of necessary support services that allow us to provide you with quality care. All tests, procedures, medications, supplies and therapies you receive while in the hospital are charged separately either for inpatient or outpatient status. An itemized statement is available upon request after your discharge.
Your hospital stay may consist of three separate bills:
- CHI Mercy Health bill for your care;
- A second CHI Mercy Health bill for professional services such as physician, PA or anesthesia services;
- Essentia Health, or Sanford Health for your physician, radiologist and/or pathologist.
Insurance
Claims will be submitted shortly after hospital services are completed. Known co-pays and/or deductibles will be required prior to the time your outpatient services are rendered or prior to discharge for inpatients.
Regardless of the type of insurance patients have, ultimate responsibility for a hospital bill rests with the patient. If insurance carriers do not make a payment within 60 days following the date insurance is filed, the account will become the patient’s responsibility and payment in full will be required.
Medicaid Renewal
If you currently receive health insurance through Medicaid or Children’s Health Insurance Program (CHIP), you must renew your benefits this year to maintain health insurance coverage. Learn more on how to renew.
Self-paying (uninsured) patients
Payment is requested prior to or at the time that your outpatient or inpatient services are rendered. If payment arrangements are not made at discharge or the day services are rendered, payment in full is expected upon receipt of your first billing.
Self-pay discounts shall be offered to those patients who are considered 100 percent self-pay, fail to qualify for any federal, state, county or local assistance programs, or are determined to have the ability to pay or have 100 percent non-covered services. Patients must also fail to meet financial assistance guidelines. The self-pay discount is offered only when the patient pays the total balance within 60 days or agrees to pay the balance in full within an 18-month period in accordance with a written payment schedule.
If you have questions regarding your bill, please contact our Business Office at 701-845-6400.