Patient Billing and Payment Policy Information
A person who comes to Seminole Memorial Hospital (SMH) seeking emergency services will receive a medical screening examination and necessary stabilizing treatment regardless of the person’s ability to pay.
SMH Financial Assistance Program
The Patient Financial Services Office may interview all self-pay patients coming to SMH for out-patient services. The Patient Financial Services Office will assist patients in determining if they are eligible for financial assistance. Patients not eligible for assistance will be required to pay a deposit before services are rendered. The deposit will vary depending on the services to be rendered. Patients unable to pay the required deposit may be rescheduled or denied services. These are only deposits and not payments in full. The Patient Financial Services Office can be reached by calling (432) 758-4951.
Patient Financial Services
The Patient Financial Services interviews all self-pay patients who are admitted to SMH. A counselor will visit with self-pay patients to determine if they are eligible for financial assistance and can assist with the application process as appropriate. Persons living in Gaines County who meet certain income and asset guidelines may be eligible for the Gaines County Medical Indigent Program. This program requires the completion of an application and patients must provide information and documents such as proof of income and residency. Each case is different and may require additional information. The Patient Financial Services Department can be reached by calling (432) 758-4951.
Patients who do not have healthcare coverage and who do not qualify for any other programs will automatically receive a 30% discount on hospital services. This discount is only for services rendered by SMH.
If you have Health Insurance:
Depending on your health insurance coverage, you may be personally responsible for payment for hospital services and for services provided by your doctor or other healthcare providers. Please contact your health plan to confirm benefit coverage, deductibles, co-payments, co-insurance and other plan provisions that may impact your responsibility for payment.
Disclosure of Participation in Health Plan Network
You have the right to request a written disclosure at the time you are first admitted to or treated that provides confirmation whether the hospital is a participating provider under your health plan. If you receive services in the emergency department or admitted on an emergency basis, you will receive a written disclosure concerning the hospital’s participation in your health plan before you are discharged. Some facility-based doctors at the hospital, such as, emergency room doctors and anesthesiologists, and other healthcare providers may not be in the same health plan network as the hospital and may not be in your health plan’s network. This may result in more out-of-pocket expense for you. You may request a listing of facility-based doctors who practice at the hospital. Please call the Medical Staff Office at (432) 758-4768 to request the list. You also may request information from these doctors on whether they have a contract with your health plan and under what circumstances you may be responsible for payment of any amounts not paid by your health plan. Please contact your health plan to verify if the doctors or other healthcare providers who will be treating you are in the plan’s network.
Receiving Separate or Additional Bills
You can expect to receive a bill from the hospital as well as separate bills from various doctors and other healthcare providers for their professional services. Usually, more than one doctor will care for you at the hospital and you may receive several doctor bills (attending doctor, surgeon, radiologist, etc.).
Requesting Estimated Charges for Services
The hospital will provide you with an estimate of hospital charges for any elective inpatient admission or non-emergency outpatient surgical procedure or other service on request before the scheduling of the admission/service. The estimate will be provided within ten (10) business days of the request. Please call Patient Financial Services at (432) 758-4951.
Patient Financial Services Department
The Patient Financial Services Department can assist you with questions about your hospital bill or insurance billing questions. The Patient Financial Services Department will also assist you with setting up an acceptable monthly payment plan for unpaid balances free from interest charges.
You have the right to receive a free copy of your itemized billing statement of hospital charges for services if the request is made within one year from the date of discharge from the hospital. Once requested, you will receive an itemized bill within ten (10) business days.
Please call the Patient Financial Services Department at (432) 758-4951.
If you have questions or concerns about any patient financial issues, you should attempt to resolve it with the appropriate staff and/or manager in the Patient Financial Services Department, (432) 758-4951. If a resolution cannot be reached you may contact the SMH Compliance Office, 209 NW 8th St, Seminole, Texas 79360, or call (432) 758-4868 or 1-833-950-0009 for English or 1-800-216-1288 for Spanish. If your complaint is still not resolved to your satisfaction, you may contact the Texas Department of Health Services at Health Facility Compliance Group/MC 1979, Texas Department of Health Services, P.O. Box 149347, Austin, TX, 78714-3947.