If requested, I understand that the Handout is available in, https://www.multicare.org/patient-privacy/, www.multicare.org/patient-resources/financial-assistance/, www.yakimamemorial.org/patients-visitors/billing-information/financial-assistance/, https://www.lni.wa.gov/claims/crime-victim-claims/apply-for-crime-victim-benefits/, https://www.cms.gov/nosurprises/consumers. You may enroll at your convenience. Be sure to check your plan documents or contact your insurer for more information. VALUABLES: If I retain any valuables, such as wedding rings, jewelry, wrist watches, dentures, eyeglasses, hearing aids or other personal effects, instead of sending them home or placing them in safekeeping with MultiCare, MultiCare shall not be responsible for loss or damage to any personal property kept by me. I also understand I cannot record conversations by any means without first obtaining the permission of all persons being recorded. Subject to terms of your CarePayment agreement, you may also choose to add future charges approved by TriHealth to your CarePayment account, with all charges consolidated into one easy-to-read monthly statement. I understand and agree that, to the extent necessary to receive payment or reimbursement for services provided at MultiCare, I authorize MultiCare to access any applicable accident reports, industrial injury (workers compensation) reports and/or police, fire or other first responder reports or investigations related to my treatment or injury, as well as any records of any claims, lawsuits, insurance claims or investigations that pertain to my medical care and treatment, or the circumstances leading to same, together with any applicable consumer and/or credit reports pertaining to me. To help fulfill this purpose, we provide options for financial assistance. THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. Baptist Medical Parks Airport, Nine Mile, Navarre and Pace Andrews Institute Baptist Medical Group Baptist Heart & Vascular Institute Baptist Health Care Foundation, Copyright 1996 This list will not include disclosures made for the purposes of treatment, payment, and health care operations identified previously. If you get follow up questions from either your insurance plan or your health care provider, please respond as quickly as possible. This law does not apply to all health plans. Offering affordable, transparent financing products ensures patients can pay off their medical bills with dignity, access care when they need it and avoid unnecessary stress and anxiety. CarePayment is a healthcare finance company that helps people manage their medical expenses. has the right, subject to his or her consent, to receive the visitors who he or she designates, including but not limited to, a spouse a domestic partner (including a same-sex spouse or domestic partner), another family member, or a friend, and his or her right to withdraw or deny such consent at any time. be treated and cared for with dignity and respect; be free from any forms of restraint or seclusion used as a means of convenience, discipline, coercion or retaliation; and to have the least restrictive method of restraint or seclusion used only when necessary to ensure patient safety. PHONE, EMAIL, TEXT MESSAGING AUTHORIZATIONS: I grant permission and consent to MultiCare to contact me using any email addresses or phone numbers associated with me, including wireless (cell) numbers, for any purpose related to my care, including the availability of services at MultiCare. To get the full experience of this website, Receive a paper copy of this notice You can request a copy of this Notice at any time from any MultiCare employee. Health-Related Benefits and Services We may use or disclose information to tell you about health-related benefits, services, or medical education classes. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Let CarePayment help you with your financial journey today. Youre never required to give up your protections from balance billing. You are only responsible for paying your in-network cost-sharing. For MultiCare Yakima Memorial Hospital Patients only, MultiCare Offers Affordable Payment Plan Options, Financial Assistance is Available to Those Who Qualify, See If You Qualify for Medicaid or Other Public Insurance Programs. When you receive surgery, anesthesia, pathology, radiology, laboratory, or hospitalist services from an out-of-network provider while you are at an in-network hospital or outpatient surgical facility, the most you can be billed is your in-network cost-sharing amount. Though neither form is required for treatment, I understand that providing MultiCare a copy of my health care directive and/or power of attorney will help my care team understand my wishes. Ask us to correct certain protected health information If you feel that information we have about you in your health record is incorrect or incomplete you can request an amendment to such information. If a third party payor will not pay, I agree to pay for the services given, subject to any applicable contractual or governmental regulations. If you are unable to keep an appointment, let us know as soon as possible. For more information about the CarePayment program, visit the CarePayment website. Our healthcare finance company is built around offering healthcare providers a valuable service to help their patients pay their medical expenses and get the care they need, while protecting the financial health of the healthcare organizations that serve our communities. If you have billing questions, we are available to help Monday Friday, 7:30am 5pm. CarePayment I permit MultiCare, in MultiCares sole judgment, to determine, apply for and obtain benefits, and get paid from, any and/or all available payor sources until my bill is paid in full. Knowledge Center for Patient Engagement Solutions - CarePayment Login Make A Payment MultiCare can change the terms of this Notice, and the changes will apply to all information we have about you. "The CarePayment program made the payment process of the hospital experience painless. All MultiCare employees and personnel including contracted or agency staff. know about your medications, any equipment used, and community resources you might need. THIS NOTICE ALSO DESCRIBES YOUR RIGHTS AND SOME OBLIGATIONS MULTICARE HAS REGARDING THE USE AND DISCLOSURE OF YOUR HEALTH INFORMATION. Patients are responsible for being respectful of the property of other persons and MultiCare Health System. a physicians office). No. Inmates We may disclose your health information to a correctional facility or law enforcement official, if you are an inmate or in custody. I understand that any test result received because of such exposure may not appear in my medical record unless I am separately treated for any positive test results at a MultiCare facility. Just take a listen. WebParticipation in the CarePayment program is voluntary. If we cannot resolve your concerns, you also have the right to file a written complaint with the Secretary of the Department of Health and Human Services (HHS), Office for Civil Rights. Nope! Other: I may also be provided with other brochures or documents pertaining to my specific health conditions, now or at a later time. HEALTH CARE WORKER EXPOSURE / BLOOD TESTING: I agree that if any health care worker (including police, fire or other first responder) is exposed to my blood or other body fluids, MultiCare may test my blood, tissue or other body fluid forcommunicable disease, such as hepatitis, HIV or syphilis, or other communicable diseases. Health Facilities and Services Licensing: Let someone know if you dont understand what you are being told. WebManage Your Account Online Getting Started with CarePayment: Participation in the CarePayment program is voluntary. Pay Your Bill | TriHealth Download/ Print your UAN Card. I understand that MultiCare uses an independent agency to do this survey. FINANCIAL AGREEMENT: I agree to pay MultiCare for care at its regular rates and terms applicable to my care and any applicable health insurance coverage I have. If you dont want to use the CarePayment program to pay your balance due, you are able to cancel it at any time and the balance will be returned to the healthcare provider. Washington Specific sexually transmitted diseases, State and federal law Substance Use Disorder records that may be specially protected, Washington Behavioral health records that are specially protected in some circumstances. For additional lists, we may charge you for the costs of providing the list. Additional documents and consent forms may be required for specific procedures. If we are unable to immediately resolve your issue (process outlined below applies only to acute care settings and is NOT followed in INW ambulatory care settings): If we are unable to provide closure within 30 business days, written notice will be provided every 30 business days until we are able to review and resolve your concerns. We offer patients finance options that help people get the care they need, when they need it. DISRUPTIVE BEHAVIOR: I understand that MultiCare has a zero tolerance policy for disruptive behavior, which includes any behavior that makes it difficult for the care team to provide services. Patient Guide English | Patient Guide Russian | Patient Guide Espaol Spanish | Patient Guide Ting Vit Vietnamese, 2023 MultiCare Yakima Memorial / 2811 Tieton Drive, Yakima, WA 98902, Call Yakima Valley Memorial at 5095758000, Obtenga la atencin adecuada en el lugar correcto, Derechos y responsabilidades del paciente, Servicio de comidas para pacientes y cafetera, . More resources Understand Your Bill '55.00 ACCOUNT BALANCE PLEASE PAY AMOUNT Sl.ns.73 R erlanger The reality is that not every patient can afford to pay cash or to take on interest-bearing debt through credit cards or home equity lines of credit to cover their share of medical expenses. CarePayment is an industry leader with extensive experience in both healthcare and consumer finance. Let us know in writing if you change your mind. If you revoke your permission, we will no longer use or disclose your protected health information for the reasons covered by your written authorization unless required by law. Choose someone to act for you If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. Base your cost-sharing responsibility on what it would pay an in-network provider or facility in your area and show that amount in your explanation of benefits. SUPPLEMENTAL INFORMATION: I acknowledge that I have been provided and/or offered the following brochures or information, and I understand that additional copies are available upon request in hard copy and/or on the MultiCare website www.multicare.org. This is why its critical to give the right personal and insurance information to your healthcare provider. If you are concerned about discrimination at MultiCare, please contact us at: Privacy & Civil Rights Office:Phone: 866-264-6121Email: compliance@multicare.org, To view our Discrimination Complaints and Grievances policy, please visit: www.multicare.org/complaints-policy. We may also share your information when needed to lessen a serious and imminent threat to health or safety. Other MultiCare is part of the MultiCare Connected Care Network which is an organized healthcare arrangement (OHCA). Your insurer will pay out-of-network providers and facilities directly. We may say no to your request, but well tell you why in writing. Payment plans are set up for a period of up to 25 months but can be paid off at any time. My test results may be shared with the exposed worker and/or their health care provider(s). You are encouraged to request information from a non-MultiCare practitioner about any separate Notice of Privacy Practices followed by that practitioner at non-MultiCare offices or facilities. Please speak to a Day Kimball Healthcare patient representative at 860.963.6337, option 1 to find out more about this affordable financing option. Only registered patients Why CarePayment | Financial Patient Engagement Platform Google Chrome. This is not an introductory or promotional rate and will apply as long as you are making payments on your initial charges. The level of automation can vary based on the HIS system capabilities. Please speak to a Excela Health patient representative We are not required to agree to your request, and we may say no if it would affect your care. Dont have an online account? future charges, with all charges consolidated into one easy-to-read monthly statement, Families may be able to consolidate charges under a single account with please update to most recent version. RISKS OF TREATMENT: NO GUARANTEE OF RESULTS OR CURE: No promise or guarantee of results or cure has been made to me. WebMyChart now provides a convenient way to pay your bill, review test results, request appointments and renew prescriptions online. WebOne of our team members will be happy to assist you. DISCRIMINATION AND ACCESSIBILITY: MultiCare does not discriminate against any person on the basis of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity, or any other basis prohibited by state or federal law for the purpose of care and treatment or participation in its programs, services, activities or employment. Find out more about CarePayment at www.carepayment.com or 866.625.8532, CarePayment accounts issued by Republic Bank & Trust, Member FDIC. you need it - without financial concerns standing in your way. WebManage Your Account Online Getting Started with CarePayment: Participation in the CarePayment program is voluntary. All rights reserved. Good SamaritanMt. We are required by law to maintain the privacy and security of your protected health information. Other health care providers who have agreed to follow and abide by the joint notice of privacy practices terms described below. I understand that I am not required to accept messages in these formats as a condition of receiving services at MultiCare. You may revoke any permission by submitting a request in writing to the MultiCare Privacy Office (at the contact information under Questions and Complaints). Find It includes MultiCaresprocedures to resolve complaints. Pay Your Bill - Beacon Health System Translated copies are available. I understand the importance of telling my potential surrogate decision-makers of my wishes through the use of health care advance directive forms or others means, as my health conditions change over time. Submit Your Analyst Briefing CarePayment Board of Director 1 Board of directors The 0.0% APR (annual percentage rate) is NOT an introductory or promotional rate. Limited information about you may be used to support communication about available products or services. Blood Conservation Services We may use or disclose your health information if you have indicated affiliations with certain organizations and we believe you may be an ideal candidate who could benefit from blood conservation services. Baptist Health Care is a not-for-profit health care organization based in Northwest Florida that is committed to helping people throughout life's journey. A minor patient, regardless of age, may consent to birth control or pregnancy-related care. WebManage Your Account Online Getting Started with CarePayment: Participation in the CarePayment program is voluntary. Box 17500Pensacola, Florida 32501-7500850.434.4011. Find out more about CarePayment at www.carepayment.com or 866.625.8532 Version 1.0+ Mozilla Firefox. infection prevention restrictions, behavioral restrictions, etc., as applicable. We will not retaliate against you for filing a complaint and the quality of your care will not be jeopardized. Important Links. Thank you for choosing Baptist Health Care as your provider of choice. Choose the AutoPay Scheduling tab, select either the standard or the custom option, and follow the instructions to finish setting up AutoPay. EMAIL CONTAINING PROTECTED HEALTH INFORMATION; MYCHART: understand that exchanging email, text or other written communications with my health careprovider(s) or other members of my care team can result in protected health information being disclosed to unauthorized persons, and that MultiCare cannot control who views such information when sent in unencrypted form. Benefits of Registration. We are committed to providing quality health care and excellent service to our community. confidentiality, privacy, security, complaint resolution, spiritual care, and communication. WebComplete your online payment through a secure guest portal via MyChart. Please report any complaints or concerns to a member of your healthcare team, who will then contact the appropriate staff. Notice of Privacy Practices: This describes your privacy rights and how MultiCare may use and share my personal health information, and how its participation in various Organized Health Care Arrangements and/or Clinically Integrated Networks or other Accountable Care Organizations may impact the use of my protected health information. ePayItOnline Member Fill out this form and we will contact your provider about offering the CarePayment program. Please call our secure line at 866.625.8532to speak with a member of our US-based customer care team. CarePayment ", I was shocked there would be no interest and I could make small payments.. WebPay My Bill Patient Billing Financial Assistance Were here to help Thank you for choosing Baptist Health Care as your provider of choice. Any health care professional authorized to enter information into your medical. Under federal privacy laws, this information is called protected health information. Insurers are required to tell you, via their websites or on request, which providers, hospitals and facilities are in their networks. We understand that information about you and your medical and behavioral health is personal. Patients may not smoke any substance (tobacco, marijuana, or vaporized nicotine devices) or use any form of tobacco products on MultiCare campuses. We do not impact a patients credit history in any way. Kristie Flowers had been sick with the flu for four or five days in July before the 52-year-old registered nurse, Out-of-pocket spending for pregnant women with employer-based health plans is on the rise, largely due to higher deductibles, according to, 2023 CarePayment. Excela Health | CarePayment Patient Financing Program This includes services you may get after youre in stable condition. Commerce Bank: Member FDIC. Privacy Policy Terms of Use, . MultiCare Update your KYC information. If I am a Medicare participant, I understand that I need to pay for services that are not covered by the Medicare Program. We are committed to maintaining Financial Assistance policies that are consistent with our mission and values and that take into account an individuals ability to pay for medically necessary health care services. Visitors are not restricted on basis of race, color, national origin, religion, sex, gender identity, sexual orientation, disability, or other prohibited classification. A number of our clinics and other facilities where you receive care are classified as hospital-based clinics. I understand that MultiCare has provided me with a list of all independent providers or groups who provide care to me, together with their contact information within this handout (Understanding Your Bill section). MultiCare typically will use your information in the following ways: Treatment: We may use and disclose your protected health information to provide you with medical treatment and services and share it with other professionals who treat you. We may use and disclose your health information to different departments to coordinate activities such as prescriptions, lab work and x-rays and to. Privacy Policy Terms of Use, . you are using Internet Explorer a legacy browser that will not support all features of this website including EasySchedule. Payments can be made in person at the payment window or front registration desk from 8:30 am to 5:00 pm, Monday through Friday. These activities generally include the following: Research We can use or share your information for health research. Patients may incur additional out-of-pocket expenses at a hospital-based clinic, because a clinical service at a hospital-based clinic may be billed as an outpatient hospital service in addition to the bill for the professional service (ie, the bill from your doctor). understand the choices for treatment including alternatives (including no treatment), risks and benefits. This includes all concerns related to care received in the ambulatory setting and acute care setting. That's why we have partnered with CarePayment to provide affordable financing options to our patients who need help paying their medical bills over time. The provider and facility cannot balance bill you for emergency services. Increasingly, patients are avoiding care because they cant afford it, even if they have insurance. What is surprise billing or balance billing and when does it happen? About Us CarePayment is a healthcare finance company that helps people manage their medical expenses. Customer Care: 866.625.8532 Sales Inquiries: 503.419.3544, KLAS Research Awards CarePayment Top Patient Financing Company for 2023 - Read Press Release. To learn more about Financial Assistance options at MultiCare Yakima Memorial Hospital, call 509-575-8255 or visit www.yakimamemorial.org/patients-visitors/billing-information/financial-assistance/. Request an accounting of certain disclosures You may request an accounting of certain disclosures of your protected health information listing all the disclosures we made to others. Patients are informed of hospital and clinic restrictions to visitation based upon clinical and other criteria; i.e. the basic steps taken to review your concerns, The complaint system for the state is available online at. I understand that MultiCare offers MyChart to all patients, which provides a fully encrypted andprotected pathway for communicating with most of its providers, although not all MultiCare providers choose to utilize MyChart. 2023 Baptist Health Care, Baptist Health Care Facility in mobile menu, Button that will go back to main mobile menu called, Visit our Patient Portal Resource Section, Minimum monthly payments of 4 percent of the highest balance or $25, whichever is greater. Know your rights under the No Surprises Act. To review thisdocument, visit: https://www.multicare.org/patient-privacy/. Returning Patient Pay your bill by logging into your MyChart account. We may also use and disclose your information to other individuals (such as consultants and attorneys) and organizations that help us with our business activities. The person I nominate is known as a health care agent, attorney in fact, surrogate, or medical decision maker. Please speak to a North Kansas City Hospital Patient Financial Services representative at 816.691.2040 or 866.691.2040 (toll-free) to find out more about this affordable financing option. Deal with your bill promptly and let the billing department know if you need to make special payment arrangements. CO-INSURANCE: There may be a co-insurance for care given related to my Medicare or other insurance benefits. MultiCare Health System is committed to serving all patients, including those who lack health insurance coverage or who cannot pay for all or part of the essential care they receive. Payment: As permitted by law, we may use or disclose your health information to get payment from health plans and other entities.
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