Patient Financial Services

Financial Information

At RML Specialty Hospital, our first priority is patients. We know that billing can often be confusing. Here are some keys to understanding patient financial services at RML.

 

Hospital Bill

You will receive one or more bills for the services you received during your stay at RML Specialty Hospital. Your hospital bill includes charges for your room and board, medical supplies, laboratory testing, pharmaceuticals, radiology services, nursing and therapy care and other medical services as ordered by your physician.

 

RML Hospital Charges

Hospital charges are complex in nature and do not necessarily provide information conducive to assisting patients in estimating their potential financial liability for services rendered. Actual charges are based on the specific care provided to each patient and can differ from any estimate provided and from one patient to another depending on the complications encountered or different treatments due to the patient’s health. Please find the average RML Hospital charges by clicking here .

Since many patients that seek hospital charge information are interested in knowing what their out of pocket financial responsibility will be, RML has provided further information on patient financial responsibility as indicated below. 

For Medicare beneficiaries, please see the Medicare information below or by clicking here .

For Medicaid beneficiaries, please see the Medicaid information below or by clicking here.

For Private Insurance beneficiaries, RML has already contracted with many insurance providers for amounts significantly discounted from charges, and the patient is only responsible to pay the deductible, co-pay, and/or coinsurance amounts. Patients should contact their health plans directly for their specific financial obligations that aren’t reimbursed by insurance.

For Uninsured Patients, significant discounts are available that could result in the care being provided at no cost or at substantially discounted rates. Please see the information regarding RML’s Financial Assistance Program below or by clicking here .

In all cases, RML’s Admitting Department can assist patients in determining their out of pocket costs. Please call 630-286-4002 to discuss patient financial responsibility information with our Admitting Department. If you have any questions about patient charges, please contact our Patient Financial Services Department at 630-286-4222.

Please click here to view a consumer guide to healthcare prices prepared by the Healthcare Financial Management Association.

Please click here to view a guide prepared by the Illinois Hospital Association to assist patients in determining their out-of-pocket costs for a number of the major insurance carriers.

 

Physician Bill

You will receive separate bills from the doctors who provide medical and surgical care to you in the hospital. These physicians include:

  • Primary care physicians
  • Specialty care physicians
  • Radiologists
  • Pathologists

 

Billing Process

If you provided us with complete and accurate insurance information and an authorized assignment of insurance benefits, RML will file your primary and secondary insurance claims for you.

Most insurance plans do not provide full coverage for hospital billings. You will be expected to pay deductibles, co- payments and coinsurance charges at the time of services or at discharge.

Hospital bills are usually sent to your insurance company within four days of discharge. You will be notified of the balance on your account (minus any previous payments) after your insurance company(s) has paid its portions.

If you do not have health insurance, you may be eligible to receive an uninsured discount off of total charges. For more information prior to your service, call the Admitting Manager at 630.286.4516.

 

Additional Information

Medical bills are often unplanned and can be difficult to understand and/or to pay. RML Patient Financial Services representatives are available to explain your bill, answer billing or insurance questions, arrange payment options or provide applications for financial assistance concerning your bill.

Phone:
Patient Financial Services 630.286.4402

Mail:
RML Specialty Hospital
PFS Department
5601 South County Line Road
Hinsdale, IL 60521

 

Insurance Companies

Contracted Insurance

If you have health insurance (i.e, PPO, HMO, POS, etc.) please refer to either your benefit plan hand book or contact your insurance company to familiarize yourself with available benefits including deductibles, co-insurance and pre-certification requirements. RML participates in the following managed care plans:

Blue Cross/Shield of Illinois – all plans
Chandler Group – Preferred Plan Cigna
Corvel
First Health
Great West Health Care HFN
Humana HMO/PPO Multiplan
Paradigm
Personal Care
PHCS
Providers First
Three Rivers PPO
UHC HMO/PPO

Contracts change frequently; always check with your insurance company for the most current information regarding your individual benefits.

RML will submit bills to your insurance company when complete information is supplied. Please remember that your policy is a contract between you and your insurance company and you have final responsibility for payment of your hospital bill. RML makes every effort to work directly with your insurance company. On occasion, we may solicit your help in resolving eligibility and payment issues.

 

Medicare

Because most of our patients are eligible for Medicare, we’ve included the following overview to help you understand the coverage Medicare provides.

 

2017 Medicare Hospital Coverage

Medicare Part A pays inpatient hospital’s semiprivate room & board, general nursing and other hospital services and supplies. Medicare provides 60 regular days and 30 coinsurance days. You are also eligible to elect to use your 60 lifetime reserve days. Lifetime reserve days can only be used one time.

Hospital days you pay:

Day 1 – 60 (60) The 1st day as an inpatient to a hospital the beneficiary is responsible for paying $1316.00 deductible. Medicare pays 100% of eligible charges for the remaining 59 in-patient days.
Days 61 – 90 (30) These are considered co-days, Medicare will pay all but $329.00 each co-insurance day.
Days 91 – 150 (60) These are considered Lifetime Reserve (LTR) days. Medicare will pay all but $658.00 each LTR day.
Days 151 + Medicare will not pay any services.

Medicare refers to each hospital admission as a benefit period or spell of illness. You must be out of a hospital or skilled nursing home for 60 consecutive days before your regular and coinsurance days renew back to 60/30. Your LTR days will not renew, only the days not used in a previous hospital/SNF stay will be available for your use on your next hospital visit.

Most beneficiaries purchase Medigap insurance to help cover the deductible and co-payments not covered by Medicare. Depending on which supplemental plan you have purchased, you could have coverage for additional 365 days after Medicare Part A exhaust.

Medicare Part B covers most physician services and supplies used for outpatient services. Medicare pays 80% of the Medicare approved amount. You are responsible for 20%.

Medicare Part B monthly premium is $134.00.
Medicare Part B deductible is $183.00.

For additional coverage and information, call Medicare toll free at 800-633-4227 (TTY: 877-486-2048) or visit the website at www.medicare.gov.

 

Medicaid

RML is a participating provider in the State of Illinois Medicaid Program. Medicaid beneficiaries and other interested in Medicaid eligibility should contact their Local Office of Social Services for more information regarding benefits, coverage and managed care options.

 

FINANCIAL ASSISTANCE PROGRAM 

Financial Assistance Application (PDF)

 

PLAIN LANGUAGE SUMMARY OF RML’S FINANCIAL ASSISTANCE POLICY

It is the policy of RML Specialty Hospital (RML) to provide financial assistance to uninsured patients in need. Medically necessary care is provided free of charge to uninsured patients whose family income is less than 200% of the Federal Poverty Level (FPL), and is provided at a reduced amount for uninsured patients whose family income is between 200% and 600% of the FPL. RML will not charge any uninsured patient for medically necessary care an amount greater than the Amount Generally Billed (AGB) to patients with insurance, which is the lesser of the amount Medicaid would have paid for that patient’s hospital stay or 135% of the hospital’s cost to provide the care. Patients are required to complete an application for Financial Assistance, provide documentation supporting their income, assets and residency, and cooperate with RML in demonstrating their inability to pay for medically necessary care provided. Financial Assistance is available only to patients who do not have private health insurance or public health coverage such as Medicare, Medicaid or other government programs. To apply for Financial Assistance, please contact our Admitting Manager at 630-286-4002 or access the Application for Financial Assistance located on our website and submit the application along with any supporting documents to our Admitting Manager at:

RML Specialty Hospital
5601 S. County Line Rd.
Admitting Department
Hinsdale, IL 60521

Financial assistance may be granted to patients on a presumptive eligibility basis if certain criteria are met or if the patient does not complete the Financial Assistance application. The plain language summary of RML’s Financial Assistance Policy, as well as the Financial Assistance Application, are also available by contacting the Admitting Manager at 630-286-4002.

Please note that if a patient is eligible for either free care or a discount from hospital charges, independent physicians rendering services may not be subject to RML’s FAP. A listing of those providers who are and are not subject to RML’s FAP is available on RML’s website by clicking here and is also provided to patients upon admission. The list is updated on a quarterly basis.