Frequently Asked Questions

Questions Concerning Financial Assistance/Payment Options:

Can I pay my bill using a credit card?
Yes, we accept MasterCard, Visa, and Discover. You may pay using your credit card by filling out the information on your bill or by calling the Patient Financial Services department at 309-836-1524.

Does McDonough District Hospital offer financial assistance or monthly payment options?
Yes, McDonough District Hospital offers financial assistance to those who qualify and accepts a wide variety of payment options . We will assist in resolving any outstanding balance, which could include free or discounted terms and monthly payment arrangements.  Call the Financial Assistance Office at 309-836-1528 or 309-836-1529 for questions or assistance.

What if I don’t have health insurance?
Emergency services will never be delayed or withheld on the basis of a patient’s ability to pay. If you do not have health insurance, please contact one of our Financial Counselors. The counselor will review payment options that may be available to you. These could include applying for Illinois Medicaid programs, extended payment plans, and financial assistance through the hospital. You may download a printable financial assistance application that you can complete and return to the Financial Assistance Office.   

What happens if my account is delinquent?
When a balance is due, you will receive a statement in the mail. If the balance is a hardship, it is your responsibility to let us know you are having difficulty paying the balance. We have many different options to assist you including payment arrangements, and a financial assistance program which may help with all or part of your bill. Failure to notify us that you need assistance may result in your account being referred to a collection agency.  Contact the Financial Assistance Office at 309-836-1528 or 309-836-1529 to discuss payment options.

I have received a letter from a collection agency. Why?
You will receive a statement from the hospital when your insurance carrier has paid or denied your claim and the balance is due from you. If your balance is not paid within 30 days from the hospital statement date, we will continue to send correspondence in an effort to resolve your account balance. If you have not contacted us regarding financial assistance or made suitable payment arrangements, then the account will be referred to a collection agency. Generally this can be avoided by a timely call from you to our Financial Counselors at 309-836-1528 or 309-836-1529.   

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Questions Concerning Billing:

Who do I contact if I have a question about my bill?
You may contact a Patient Financial Services Representative at 309-836-1524 or send an email message to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .  

Are my physician charges included in my hospital bill?
Depending on the services you received, you may receive other bills from your personal physician, surgeon, or other medical service providers. Please refer to the physician fees section of this billing guide for further information. 

How do I get an itemized bill?
We would be happy to give you a copy of your detailed bill.  Please contact the Patient Financial Services department at 309-836-1524.

Why do I have so many different account numbers?
Insurance companies require hospitals to bill each visit separately, excluding some services that are billed on a monthly basis. We are required to keep separate documentation for each visit to comply with regulations. Therefore, we maintain separate visit accounts for each patient encounter. If the balance is due from you, you may contact our Financial Counselors at the Financial Assistance Office to combine the accounts and receive one bill after each new visit. 

What if there is an error on my bill?
If you believe that your bill is incorrect, contact us and we will be happy to discuss it with you.

What if I want to dispute my bill? 
We will attempt to address any questions or concerns you may have about your bill. Our Patient Financial Services Representatives are available Monday through Friday from 8:00 a.m. to 5:00 p.m. You may also submit your questions in writing, by mailing your request to McDonough District Hospital, 525 E. Grant, Macomb, IL  61455 Attn: Financial Assistance Office. Please note that if you have a concern , you may also access a Patient Advocate in the Advocacy Services department by calling 309-833-4101.

What if I did not supply my insurance information?
It is important that you contact us with your information immediately in order to prevent pre-certification and timely filing issues with your insurance plan. You can contact our Patient Financial Services department at 309-836-1524. 

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Questions Concerning Insurance:

How do I know if MDH is a “participating provider” with my health plan?
Your health plan may require you to receive services at an “in network” or “participating provider” hospital in order to receive full benefits. Please call your health plan to verify its requirements and to be sure MDH is in your network.
 
Can I still go to MDH if they are “out of network” for my plan?
In an emergency you should go to the closest hospital. Your health plan will generally cover these costs or transfer you to an “in network” hospital if it is safe to do so. If you elect to go to an “out of network” hospital in a non-emergency, you may be required to pay a larger deductible or a greater portion of your bill. Be sure you understand your “out of network” options with your health plan.
 
Will the hospital bill my insurance(s) for me?
Yes, in exchange for assigning your insurance benefits to us, we will file claims on all accounts in which there is complete insurance information (insurance name, address, policy number, group number, etc). If you have a secondary insurance company, a claim will be submitted to the secondary insurance company after the primary insurance company has paid. It is important to remember however, that the hospital relies on you for settling your account in full regardless of your insurance coverage. Your insurance policy is an agreement between you and your health insurance carrier. 

How long will it take my insurance company to pay their portion of the bill?
On average, an insurance company will process a claim within 45 days. We will follow up with the insurance company periodically to expedite the resolution of the claim.  

How can I be sure my health plan will pay my hospital bills?
Some health plans require a patient to pre-certify certain services, or to notify them within a certain period of time after becoming hospitalized. If your hospitalization is not an emergency, we encourage you to review and understand your insurance benefit documents your health plan or employer has provided you. In these cases, check your health policy plan and handbook, or call the telephone number on your insurance card for more information. For elective procedures, you should talk to your doctor’s office and your health plan about coverage.

Why do I need to call the insurance company if they do not pay the bill?
We will make every effort to collect payment on the account from your insurance company, however you are ultimately responsible for the total bill or any portion of the bill your insurance plan does not pay.  

How will I know how much I owe?
Your health plan will send you an Explanation of Benefits (EOB) notice which provides the amount it has paid, any non-covered or denied amounts, and the remaining balance that you owe. Please review this carefully and call your health plan if you have questions. We will also send you a bill for any remaining amount due (deductibles, co-insurance, non-covered charges).    

Why did my insurance pay only a part of my bill?
Most insurance companies require that you pay a co-payment, co-insurance, and/or a deductible for your healthcare expenses. Further, your physician may have ordered tests or procedures that your health plan does not cover. You should receive an Explanation of Benefits (EOB) from your insurance company showing how they considered your claim. Contact your insurance company for specific information pertaining to your coverage. 

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Questions Concerning Medicare:

What is an Advanced Beneficiary Notice (ABN)?
An ABN is a written notice that a provider gives to a Medicare beneficiary before outpatient Part B services are furnished when the provider believes that Medicare will not pay for some or all of the services. Our staff is required to check the medical necessity of a patient's outpatient test/procedure to determine if it meets appropriate criteria prior to the rendering of the service. If the test/procedure on the physician's prescription does not reflect an appropriate diagnosis code per Medicare standards, the patient/guarantor will be asked to sign an ABN which states that should Medicare deny payment for this service, the patient/guarantor will accept financial responsibility and be “personally and fully responsible for payment.” To be “personally and fully responsible for payment” means that the beneficiary will be liable to make payment out-of-pocket, through other insurance, or through Medicaid or other federal payment source. We must issue notices each time and as soon as we make the determination that Medicare payment will not be made.

Why does the hospital routinely give me an Advance Beneficiary Notice (ABN) for certain services?
We may routinely issue ABNs for services or items that are covered by Medicare, but that are only covered up to a certain number of times within a specified amount of time. Examples of “frequency limited” services include laboratory tests, some preventive screening tests, and vaccinations. If you receive an ABN that gives a frequency limit as its reason, it means that Medicare will not pay if you exceed that limit on the service. 

What is the Medicare Secondary Payor (MSP) Questionnaire and why must I complete it each time I'm a patient at McDonough District Hospital? 
Medicare requires that a series of questions be asked UPON EACH VISIT to a hospital facility, whether you are an inpatient or outpatient. These questions are part of a form called the Medicare Secondary Payor Questionnaire. Each time you arrive at MDH for any type of service (emergency care, outpatient or inpatient), registration staff will ask specific questions to determine which insurance company will be the primary payor for your bill. Medicare is NOT always the primary payor and governmental guidelines demand that hospitals verify if any other insurance coverage could be primary. Examples: If your care is related to an auto accident or work-related accident, the auto insurance coverage or worker's compensation coverage will be primary. If you are working and still retain insurance from your employer, the group insurance will be primary.

Does McDonough District Hospital bill for Medicare Part D - Self-Administered Drugs?
No, McDonough District Hospital is not a Medicare Part D provider so we cannot bill Medicare Part D; you must do that yourself. Per your request, we will mail you an itemized statement detailing the self-administered medications you received so you can send that bill to your Medicare Part D carrier. To file a Medicare claim yourself, you will need to print out and complete the form called Patient’s Request for Medical Payment, Form CMS 1490S. The form is available for download on www.cms.hhs.gov in the CMS Forms section. Once there, you will need to do three things: (1) print out the 1490S form; (2) select and print out the applicable instructions; and (3) review all of the information on this page about how to file a claim form. If you have questions, call 1-800-Medicare (1-800-633-4227).

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