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A method of billing at the Adams Memorial Hospital for non-Medicare patients will be changed after hospital officials received a legal opinion from Indianapolis telling them it would be legal to do so.
Last year, the hospital began charging Medicare and non-Medicare patients who sought care from the offices of Dr. David Coats, Dr. Crystal Jencks, and Dr. Jessamine Hippensteel two separate fees, one of which was for professional services, and the second for a facility charge.
The hospital does the billing for these three physicians since they are hospital employees. The hospital received inquiries from many patients about the charges since the facility billing had been done differently in the past.
Hospital officials explained that since the orthopaedic office (Coats) and the Decatur Family Medicine office (Jencks and Hippensteel) became departments of the hospital, Medicare allowed a facility charge to be made. A brochure was designed by AMH officials in order to try and explain the new method to patients, but as Adams Health Network Board of Trustees president Dr. Robert E. Judge said Wednesday night at the trustees' monthly meeting, he was hearing discontent over the billing procedure.
The majority of discord came from non-Medicare patients. A patient with private insurance normally had to make a co-pay at the time of the visit with the physician, and insurance paid the balance of what had not been written off as a result of the insurance company contract with the hospital. The new facility charge, however, was being tagged to the patient's deductible so some patients were paying not only the co-pay but the deductible.
AHN President and Chief Executive Officer Tom Nordwick told the trustees Wednesday night the hospital sought a legal opinion from an Indianapolis law firm that specializes in hospital law and the result is the hospital will no longer be billing non-Medicare patients the facility charge.
Patients will receive a bill with just one charge, although the fee will be increased. The new policy does not affect billing of Medicare patients, Nordwick said.
In another billing issue that was brought before the trustees, Nordwick said he has been approached by Amish representatives seeking significant discounts on hospital charges since they do not carry health insurance.
Nordwick said that while he has left the door open for them to organize as a group and negotiate, he spoke of the "fairness aspect" of discounts saying, "You can't have a special deal for each person who comes through the door."
Nordwick told trustees he is awaiting a response from the Amish contingent. The hospital does offer a specific discount to any individual without insurance who pays for a hospital charge within 30 days, but that discount pales in comparison to what is being sought by several Amish individuals.
In a report to the trustees near the end of the meeting, Nordwick noted that officials at Fleetwood in Decatur have requested the hospital to staff a medical clinic one of their locations. He said senior leadership staff is reviewing the request and looking at its feasibility but no decision has been made.