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Insurance and Billing

Managing Your Billing Process After a Stay at OhioHealth Shelby Hospital

We work closely with your health insurance provider regarding the financial coverage for your hospital stay. In some circumstances, your insurance may set limits on the amount of time that you can be hospitalized for your particular illness or injury. In others, your insurance company may only pay a portion of your hospital bill.

Shelby Hospital Insurance and Billing Policies

Our mission is to meet the medical needs of those we serve. This mission requires that Shelby Hospital maintains a strong financial position. As a result, we have established a policy of communicating financial expectations to our patients. We will also provide information on payment and charity care options.

Our employees respect a patient’s financial status and hold such information in the utmost confidence. With the exception of “lifestyle” procedures, no clinical services will be denied for an inability or unwillingness to pay.

Contact Billing Information Services at (419) 526.8428 for more information regarding your bill.

Call Patient Financial Counseling at (419) 526.8464 for payment assistance.

OhioHealth Shelby Hospital's billing and credit policies are summarized below.

Accepted Health Insurance

Other Insurance Options

Third Party Insurance

Shelby Hospital will bill Medicare and Medicaid.

Shelby Hospital will bill third-party commercial payers on behalf of the patient. We offer 45 days to the insurance company before you will be contacted to assist with the resolution of any unpaid insurance balance. If there is no resolution, the account will become patient liability and the patient will be billed.

Shelby Hospital will not bill third-party insurance if there is medical coverage available.

Shelby Hospital will not wait for a third-party liability carrier or sued individual to pay a claim before enforcing our right to payment. Shelby Hospital will not accept a letter of protection from an attorney involved in a law suit to recover third-party damages.

Shelby Hospital will honor discounts only with contracted insurance carriers.

 

Uninsured, Unresolved and Self-Pay Balances

Emergent, Urgent and Labor and Delivery services covered under EMTALA (Emergency Medical Treatment and Active Labor Act) are not subject to prior payment.

Known Deductibles, Copay and Coinsurance amounts are due at the time of service.

Non-covered, self-insured, uninsured and "lifestyle" services are payable at the time of service. (Lifestyle procedures are defined as not medically necessary procedures, such as non-restorative cosmetic surgery.)

Patient balances that cannot be paid prior to service and balances after insurance payment or denial must be resolved in one of the following methods:

  • Payment in full from personal funds
  • Bank Loan Program underwritten by OhioHealth Shelby Hospital
  • Limited term time payments (limited to 6 months)
  • Uncompensated or Charity Care approvals

Patient balances not resolved in one of the methods above will be billed on a prescribed time table over a 120 day period. During each of those billing encounters, calls from a financial counselor will include information about the above payment options, as well as our uncompensated care program.

If the account has not had a satisfactory resolution within 120 days, the claim may be submitted to an outside agency for professional collection assistance.

Financial Assistance

If you are in need of financial assistance, please read the following Financial Assistance and Charity Care information:

Financial Assistance Policy Summary (includes phone numbers and addresses of who to contact for help)
Financial Assistance Application Instructions
Financial Assistance Application
HCAP Charity Worksheet
List of Providers at Shelby Hospital
OhioHealth Financial Assistance Policy