Financial Assistance
You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. For more information, contact the financial assistance representative at 618-847-8244.
Click here to download the application
Insurance and Pre-Certification
To ensure your peace of mind while you are hospitalized, we suggest that prior to your admission you be aware of the type of coverage your insurance policy provides. Check with your place of employment or your insurance company for any unique requirements. It is your responsibility to determine if pre-certification is required and to provide your insurance company with the appropriate information prior to your hospital visit. You will need to bring your insurance card and your pre-certification number when you come to the hospital. If you need assistance, please call Registration at 618-847-8275.
Regarding Your Bill
Fairfield Memorial Hospital contracts with several physicians and groups to provide professional services to patients. In addition to receiving a bill for services provided at Fairfield Memorial, you will be billed a professional fee separately if you receive services provided by:
- Pathology
- Radiology
- Cardiopulmonary/Sleep Study Lab
For your convenience, the telephone numbers for some of the professional bills you may receive are listed below:
Fairfield Memorial Hospital – Business Office 618-842-2611
Richland Radiology 618-262-7303
Pathology Services 877-612-2085
Weber Medical Clinic 618-395-522
The Neurology Group 615-855-1374
Southern Illinois Primary Care Associates 618-842-4470
The Heart Group 812-464-9133
Dr. Anthony Vacca 618-242-8900
Dr. Lori Guyton 618-993-0444
If you have billing questions concerning any of the services with which we contract, please call the service directly.
Thank you for using Fairfield Memorial Hospital. We appreciate your confidence in us by choosing us as your healthcare provider. We offer the following information concerning our credit policy to help you understand the responsibility for payment of patient accounts and to keep to a reasonable minimum the amount of time necessary to settle balances. We must rely entirely on patient revenue for operation of this facility, which provides 24-hour-a-day quality services from a full staff of professional and specialty skilled employees.
Business Office
The Business Office is open Monday through Friday, 8:30 a.m. to 4:30 p.m. All patients, with the exception of those on Illinois Medicaid, will be mailed a copy of their bill. Please contact our staff by phone at 618-842-2611 or in person should you have any questions or concerns regarding your hospital bill.
Insurance
Claims are filed upon the patient’s behalf based on the information provided at the time of registration. Fairfield Memorial Hospital assumes no liability for pending, delayed, or disputedmedical claims. The guarantor of the patient bill will be billed for any remaining balance after the insurance has paid their portion. If no payment has been received from the insurance company 30 days after they were billed, we will look to the guarantor for payment. Any insurance payment received after the guarantor has paid the balance will be refunded to the guarantor.
Pre-Certification Requirements
If any insurance company or third-party payer requires pre-certification, it is the responsibility of the insured to contact them to obtain authorization for services. Additionally, some physicians may not be participating providers in the same insurance plans and networks as the hospital.
Medicare
Claims are submitted to Part A and/or Part B Medicare upon the beneficiary’s behalf. In addition, up to two Medicare supplemental insurance of the patient’s choice will also be filed. The beneficiary is responsible for any deductible and/or co-insurance and non-covered services (such as a private room) not paid by their insurance.
Private Pay
Payment in full is expected at the time service is provided and should be paid through one of these payment alternatives: cash, check, or credit card (MasterCard, Visa, or Discover).
Payment Arrangements
If unusual circumstances make it impossible to pay the balance when a bill is received, we invite you to call or personally discuss the matter with a financial representative who will set up mutually agreeable monthly payments based on the amount of the bill and guarantor income and expenses. This will avoid misunderstanding and enable you to keep your account in good standing.
Returned Checks
Checks returned for non-sufficient funds will have a service charge of $15.00 added to the account balance.
Delinquent Accounts Failure to meet financial obligations may result in delinquent accounts being assigned to a collection agency or attorney for recovery.
Illinois Department of Public Aid
Recipients are responsible for presenting their medical cards at the time of registration. It is important that you be aware that there is a time deadline for submitting claims to the state. If you fail to furnish your medical card to the Business Office within the required time frame, you will then be held responsible for payment of your bill even though you were covered by a valid medical card at the time of service.
