Financial & Insurance Information

Billing Process

You will be billed as soon as possible after your visit to Tri-State Memorial Hospital. Typically, bills are not sent until all insurance claims have been processed.

The bill due date will depend on your account balance, as follows:

• Account balances less than or equal to $500 are given 90 days to be paid in full.
• Account balances greater than $500 are given one year from the first billing statement to be paid in full. Please contact the Business Office at 509.758.4652 to establish a contract of payment.
• All payments are due in the Business Office by the 25^th of each month.

Hospital-Based Outpatient Care

“Provider-Based” or “Hospital-Based Outpatient” refers to the billing process for services rendered in a hospital outpatient clinic or location. This is the national model of practice for integrated health systems involved in patient care and Tri-State follows these very specific billing practices as mandated by the Center for Medicaid & Medicare Services.

This means that patients may receive two bills: one from the hospital (the technical component) and one for the practitioner’s professional services. For additional information on the facility charge, follow this link.

Credit Policy

Financial arrangements must be made with the Business Office prior to your discharge from Tri-State.

Scheduled admissions, such as surgery appointments, must make financial arrangements prior to admission. A deposit will be requested for the portion of the billing not covered by insurance, such as co-payment, coinsurance, non-covered and deductible amounts.

If you cannot pay your bill in full at the time of the first billing statement, please contact the Business Office at 509.758.4652.

Charity Care

Tri-State offers Charity Care, which is a way to help low-income patients and families pay for hospital medical services. To find out more about Charity Care, what is needed to prove you are eligible, and what services will be covered, please contact the Business Office at 509.758.4652.

Prompt Pay Discount

A prompt pay discount of 10% will be given on uninsured accounts greater than or equal to $500 if paid in full within 30 days of the first billing statement.

Late Payments

A finance charge will accrue on accounts not covered by insurance 60 days after the first billing statement. If your account is pending payment by insurance, the finance charge will begin accruing on the self-pay balance, or the amount you’re responsible for, 60 days after Tri-State receives payment from your insurance.

If your insurance does not pay within 60 days, the account will be considered a self-pay account and interest will accrue on the full balance.

The effective interest rate will be 1% per month. The finance charge will be figured by applying the monthly interest rate to the adjusted account balance (the previous balance minus any payments/credits plus any new charges). The minimum finance charge for any balance is $0.50.

Insurance

Tri-State Memorial Hospital will bill your insurance company if your current insurance card is presented at the time of registration. You will be asked to sign a form authorizing your insurance company to assign benefits to Tri-State when you register.

You are expected to pay for charges that are not covered by insurance, such as co-payment, coinsurance, non-covered and deductible amounts. It is your responsibility to meet the requirements of your insurance policy for pre-approval of hospital services.

Questions regarding your insurance coverage or benefits must be directed to your insurance company.

Contracted Payors

• Regence Blue Shield of Idaho
• Blue Cross of Idaho
• Uniform Medical Plan
• Premera Blue Cross
• First Choice
• Aetna
• Molina
• Idaho Medicaid
• Washington Medicaid
• Noridian Medicare
• Sterling Medicare
• Regence Blue Shield of Idaho, Medicare Advantage
• Blue Cross of Idaho, Medicare Advantage
• Cigna (effective September 1, 2010)

 
Questions relating to a provider’s preferred, participating, network or non-network status will be the responsibility of the patient. The patient is responsible for meeting the requirements of their insurance policy and all questions regarding insurance coverage or benefits must be directed to your insurance company.

Medicare

Tri-State will bill Medicare, and your Medicare supplement, for services you received. For any service not covered by Medicare, you will be asked to sign an Advance Beneficiary Notice (ABN) prior to treatment.

Medicaid

You must present your current medical coupon or card at the time of registration. Tri-State’s Registration staff will verify eligibility prior to treatment.

Workmen’s Compensation

The Business Office will need the following information for services rendered that are the result of a work related injury:

• Employer name, address and phone number
• Date of injury
• Claim number, if applicable

 
You must notify your employer about an on-the-job injury. Your employer will need to submit additional information.

Auto Insurance

The Business Office will submit a bill on your behalf for services related to a motor vehicle accident once the following information is received:

• The name of the responsible party
• The name and phone number of the responsible party’s auto insurance company, and the agent’s name
• Your auto insurance company, phone number and agent name

Contact the Business Office

Please call the Business Office at 509.758.4652 between the hours of 8 a.m. and 5 p.m., Monday through Friday, for help with:

• Applying for free or discounted care
• Questions about your bill

Helpful Phone Numbers

Many doctors, ambulance companies and labs are separate businesses with their own billing and account procedures. Below is a list of groups who regularly provide care for patients at Tri-State Memorial Hospital. If you receive a bill from them, please contact them with any questions.

• Twin Cities Radiology – 509.758.6132
• Pathologists’ Regional Laboratory – 800.443.5180
• Lewiston Orthopedic Associates – 208.743.3523
• Valley Medical Center – 208.746.1383
• Clearwater Anesthesia – 509.254.5077 or 509.464.1175
• Lewiston Ambulance – 208.743.3556
• Lewis Clark Gastroenterology – 208.746.3309