Patients & Visitors

Hospital Bills and Insurance

All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the hospital's billing procedures and charges. If you have any questions about your bill, please call the Business Office at 937.599.1405 or ext. 1405 from your hospital phone.

If You Have Health Insurance

We will need a copy of your health insurance identification card in order to process your registration. We also may need insurance forms, which are supplied by your employer or the insurance company. You will be asked to assign benefits from the insurance company directly to the hospital.

If You Are a Member of an HMO or PPO

Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan's requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your healthcare plan and their services may not be covered.

If You Are Covered by Medicare

We will need a copy of your Medicare card to verify eligibility and process your Medicare claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others. Deductibles and co-payments are also the responsibility of the patient.

If You are Covered by Medicaid

We will need a copy of your Medicaid card. Medicaid also has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless medically necessary.

If You Have No Insurance

A representative from the Business Office will discuss financial arrangements with you. Assistance is available to you in applying for Medicaid or other government assistance programs. If payment in full cannot be made at the time of service, Mary Rutan Hospital's Business Office has special account representatives available to discuss payment options with you.

Your Hospital Bill

The hospital submits bills to your insurance company and will do everything possible to expedite your claim. But you should remember that your policy is a contract between you and your insurance company and you have the final responsibility for payment of your hospital bill. If Mary Rutan Hospital does not receive payment from your insurance company within 30 days, or your insurance company denies your claim, you will receive a statement with the balance due within 10 days. If you do not have insurance, you will receive a bill within 30 days of your discharge date.

If you have certain tests or treatments in the hospital, you may receive additional statements from the following physician specialty groups affiliated with our hospital. These charges are not part of your hospital bill. If you have any questions regarding your account with these groups, please contact them directly.

Financial Assistance

If you are uninsured and need help with paying your hospital bill, you may qualify for one of our financial assistance programs. These programs are designed to assist patients who are either financially or medically unable to fully pay for their hospital services.

By simply filling out an application and confidentially providing a form of income verification, we can best assist you with possible options.

Applications for financial assistance can be obtained in the registration area, on our website or by contacting the Business Office. Once completed, return the application to registration or the Business Office for review.

Disclaimer and Explanation for Standard Hospital Charge

This hospital determines its standard charges for patient services with the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient's bill. These are the baseline rates for services provided at this hospital.

The chargemaster is similar in concept to the manufacturer's suggested retail price (MSRP) on a vehicle. It is the starting price of each service performed and goods consumed associated with the individual patient's treatment. The chargemaster rates are updated from time to time to accurately reflect the hospital’s expenses to operate.

Standard charges shown in the attached file do not necessarily reflect what a patient may pay. Government insurance plans such as Medicare and Medicaid do not pay the chargemaster rates, but rather have their own set rates which hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with managed care payors and may or may not reflect the standard charges. Patients without commercial insurance or not covered by a government health care plan should contact the hospital prior to a procedure to discuss charges, alternative pricing, and payment terms.

Download CSV version of chargemaster

Download CSV version of list of drug prices as of 12/27/2018

Download CSV version of DRG averages

Contact Us

You may receive services from these medical providers that bill separately from the hospital.

Mary Rutan Hospital Anesthesia

Billing Service:
Abeo Management, Inc.
800.919.1190

Remittance Address:
Mary Rutan Hospital
PO Box 951434
Cleveland, OH 44193

Cardiology

OSU Cardiology Associates of Bellefontaine
William A. Houser, MD, Arsad Karcic, MD, Evan Dixon, MD, Michael Donnally, MD, Vince Brinkman, MD, Jim Liu, MD
OSU Physicians Inc.
700 Ackerman Rd. Suite 600
Columbus, OH 43202
614.685.0010

Emergency Department

Emergency Professional Service, Inc.
PO Box 634704
Cincinnati, OH 45263-4704
888.952.6772

Billing Office Hours:
Monday - Friday 8:00 a.m. - 8:00 p.m. EST
Saturday 10:00 a.m. - 3:00 p.m. EST

Pathology

Mary Rutan Hospital Pathology

Billing Service:
APS Medical Billing
800.274.2158

Remittance Address:
Mary Rutan Hospital
PO Box 951434
Cleveland, OH 44193

Pediatric Cardiology

Children's Hospital Section of Cardiology
Hugh D. Allen, MD
Curt J. Daniels, MD
Douglas W. Teske, MD
700 Children's Drive
Columbus, OH 43205
614.722.6682

Radiology

Bellefontaine Radiologist Associates
4132 Elida Rd.
Lima, OH 45807
800.444.3387

2019 Price List

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© Mary Rutan Hospital, 205 Palmer Ave., Bellefontaine, OH 43311 | 937.592.4015