Insurance Information

Jackson Hospital is committed to providing quality health care and services to all patients. In order to continue this mission, payment must be received for services provided.

As a courtesy to our patients and their families, Jackson Hospital submits hospital claims to any insurance company according to the guidelines listed in this brochure. To do this efficiently it is important that insurance information be presented at the time of registration or admission. An itemized bill for services rendered will be sent upon request of the patient and/or the responsible party. Patients will receive a monthly statement for open accounts.

Patient Responsibilities

Prior Authorization

An increasing number of insurance companies now require approval prior to receiving hospital services. Most of these plans require that either the admitting physician or the policyholders initiate the approval procedure. If your insurance has such a requirement, please inform your physician or contact your insurance carrier. Failure to meet your insurance requirements may result in partial or complete denial of insurance benefits.

Payment Responsibility

An anticipated insurance payment does not replace the patient’s obligation to pay any outstanding balance. In certain situations, if insurance payment is particularly slow, or the insurance carrier requests additional information from the insured, Jackson Hospital reserves the right to make payment the direct responsibility of the patient or responsible party.

Worker’s Compensation

Charges for hospital services incurred as a result of work-related injury will be treated as a normal insurance claim. Benefits will be confirmed by the employer or claims adjuster within 24 hours of hospital admission or the next working day in the case of weekends or holidays.

Should the claim be disputed, the patient will be required to sign a form allowing the hospital to bill other insurance the patient may have in lieu of the worker’s compensation claim. If there is no other insurance, the outstanding balance will become the patient’s responsibility

Insurance Billing Guidelines

Medicare

Jackson Hospital is a certified Medicare provider. Additionally, when secondary insurance policy information is presented at the time of admission, the hospital will submit your insurance claim for deductible or coinsurance. This supplemental billing can only be completed after Medicare payment has been received and cannot be done unless complete and accurate information is received at the time of admission.

While Medicare must be allowed as much time as needed to process a claim, supplemental insurance will have up to 30 days to make payment before the outstanding balance is determined to be a patient's responsibility.

Medicaid

Medicaid billings are submitted on behalf of the patient. The patient will be notified of any balance he may owe.

Other Insurance

Jackson Hospital will bill up to three insurance companies if presented with insurance information and assignment of benefits at the time of admission. Benefits will be confirmed within 24 hours of admission or the next working day in the case of weekends or holidays. All balances not paid after 45 days of filing the claim will become the responsibility of the patient.

Accidents and Injuries

If your injury is a result of a vehicle accident or public liability, Jackson Hospital will hold you personally responsible for your hospital bills. Since such cases may require many months to resolve, the hospital cannot wait for final decisions.

Medically Needy

Patients qualified for the Medically Needy program must meet their share of cost as determined by the Department of Children and Family Services. It is the patient’s responsibility to provide the caseworker with information regarding medical bills to determine monthly eligibility. Jackson Hospital will hold Medically Needy recipients responsible for their balance if they do not meet their share of cost.

Florida No Fault Auto Insurance

Jackson Hospital is required to file an auto insurance claim under the Florida no-fault law. The insured person involved in a motor vehicle accident must submit his/her own personal PIP coverage as primary payer. Persons requesting the information or clarification of the law should contact the Florida Insurance Consumer Help Line at 800-342-2762.

When a Patient Owes a Balance

It is expected that all patients make an effort to pay any balance due the hospital. Customer Account Representatives will work with you to establish a reasonable settlement of all balances. An account is considered delinquent when:
  • No payment arrangements have been made within 30 days of final insurance payment (or final billing for self-pay accounts).
  • There is no response to phone calls and/or letters.
  • A required Financial Assistance Application form is not completed.
  • Terms of established hospital financing arrangements are not met.
All patients will receive one final notice and a grace period of 10 working days to forward any required payment information. Disputed balances will be subject to further review before collection efforts are pursued. In those cases where all reasonable efforts to collect the balances due have been exhausted, the account will be referred to a state-licensed agency or an attorney for follow-up and collection. Jackson Hospital has personnel available to assist guarantors in establishing financial arrangements to meet the needs of the patient and the hospital.

To assist the patient in meeting his/her obligations, Jackson Hospital provides the following programs:

Hospital Financing

Jackson Hospital will accept monthly payment arrangements if financial need is established. To qualify for hospital financing, the patient must complete a Financial Assistance Application. The payment will be measured against the patient’s spendable income (i.e. available income after monthly obligations). The minimum monthly payment cannot be less than $25.00.

Credit Cards

Jackson Hospital will honor Visa, American Express, and MasterCard for the payment of accounts. These payments will be accepted either in person, by phone, or by mail.

Unfunded Care

Jackson Hospital recognizes that there are occasions when a patient will not be able to pay a medical bill. Since obtaining care at Jackson Hospital is not dependent on one’s ability to pay, the hospital expects the patient to provide documentation to qualify for free or unfunded care.

The patient or responsible party must provide the following information in order to determine the appropriate amount of unfunded care to be applied to the patient’s account.
  • Financial Assistance Application.
  • Proof of income for the last three months.
  • Copy of latest federal income tax return.
Consideration for unfunded care is based on the patient’s and/or responsible party’s financial status compared to the established Federal Poverty Income Guidelines.