Financial Information

Financial Information

Our first priority is patients. However, we know that billing can often be confusing, so we are offering some keys to understanding patient financial services at RML below.

Hospital Bill

You and/or your insurance company will receive one or more bills for the services you received during your stay at RML. 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.

Physician Bill

You and/or your insurance company will receive separate bills from the doctors who provide medical care to you in the hospital. These physicians include:

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

RML Hospital Charges

Hospital charges are complex and do not necessarily provide information that helps patients estimate the amount of money they will ultimately owe. Actual charges are based on the specific care provided to each patient and can differ from any estimate provided. Total charges for an episode of care can vary from one patient to another depending on the complications encountered or different treatments provided due to the patient’s care requirements.

The Centers for Medicare & Medicaid Services (CMS) issued price transparency requirements (45 CFR § 180.50) for hospitals to provide a comprehensive machine-readable file of all items and services provided by the hospital to a patient in connection with an inpatient admission and consumer-friendly display of ‘shoppable’ services. RML is a long-term acute care hospital which does not offer services that can be scheduled in advance.  Please see below for comprehensive files:

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.

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

2021 Medicare Hospital Coverage
Medicare Part A pays inpatient semi-private room and board, general nursing and other hospital services and supply costs. Medicare provides coverage for 60 regular days and 30 co-insurance days. You are also eligible to elect to use your 60 lifetime reserve days. Lifetime reserve days can only be used one time.

Day 1 – 60 (60 days total)

  • The 1st day as an inpatient in a hospital, the beneficiary is responsible for paying a $1,484 deductible. Medicare pays 100 percent of eligible charges for the remaining 59 inpatient days.

Days 61 – 90 (30 days)

  • These are considered co-days, and Medicare will pay all but $371 for each co-insurance day.

Days 91 – 150 (60 days)

  • These are considered Lifetime Reserve (LTR) days, and Medicare will pay all but $742 for each LTR day.

Days 151 +

  • Medicare will not pay for any services past day 150.

Medicare refers to each hospital admission as a benefit period or spell of illness. You must be out of a hospital or skilled nursing facility for 60 consecutive days before your regular and co-insurance days renew back to 60/30. Your LTR days will not renew; only the days not used in a previous hospital/skilled nursing facility stay will be available for your use on your next hospital visit. Skilled nursing facility days 21-100 will be covered at $185.50 per day.

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 an additional 365 days after Medicare Part A is exhausted.

Medicare Part B deductible - $203.00/year

Medicare Part B monthly premium will be $148.50 (or higher based on your income). Medicare Part B covers most physician services and supplies used for outpatient services. Medicare pays 80 percent of the Medicare approved amount. You are responsible for 20 percent.

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

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

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-payment, and/or co-insurance amounts. Patients should contact their health plans directly for their specific financial obligations that are not reimbursed by insurance.

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.

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 percent of the federal poverty level (FPL), and is provided at a reduced amount for uninsured patients whose family income is between 200 and 600 percent of the FPL.

RML will not charge any uninsured individual eligible for financial assistance an amount greater than the amounts generally billed to patients with insurance, which is the lesser of the amount Medicaid would have allowed for that patient’s hospital stay or 135 percent of the hospital’s cost to provide the care. 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. 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 application for financial assistance.

To apply for financial assistance, patients must complete an application for financial assistance (available from our admitting department and located on our website), provide documentation supporting their income, assets and residency, and cooperate with RML in demonstrating their inability to pay for the medically necessary care provided.

Individuals may use the following contact information to obtain further information about financial assistance or the financial assistance process, or request free financial assistance information by mail:

Mailing Address:

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

 

In-Person Address:

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

Chicago
Available by appointment
Admitting Department
3435 West Van Buren Street
Chicago, IL 60624

Phone Number:
630-286-4516

Fax Number:
773-826-2851

Contracted Insurance

If you have health insurance (i.e., PPO, HMO, POS, etc.), please refer to either your benefit plan handbook or contact your insurance company to familiarize yourself with available benefits including deductibles, co-insurance and pre-certification requirements. Contracts change frequently; always check with your insurance company for the most current information regarding your individual benefits.

RML participates in most major insurance and Medicaid managed care plans. We encourage you to contact us if you have any questions. We also make arrangements for single-case agreements if we do not have a contract with your insurance company, and we provide financial assistance if eligible. Click on this link to the Financial Assistance Application for additional information.

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.

In all cases,

RML’s admitting department can assist patients in determining their out-of-pocket costs.  Please call 630-286-4516 to discuss patient financial responsibility information with our admitting department.  If you have any questions about patient charges, please contact our patient financial services at 630-286-4475.

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.

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 co-insurance 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 has paid its portions.

If you do not have health insurance, you may be eligible to receive a discount off total charges. For more information prior to your service, call the admitting department at 630-286-4516.

Additional Information

Medical bills are often unplanned and can be difficult to understand and/or to pay. RML’s 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 630-286-4475

Mail:

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

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 financial assistance policy (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 offered to patients upon admission.

Financial Assistance Application

Financial Assistance Policy

Billings & Collections Policy