Billing Services
Committed to Quality
CGH Medical Center is committed to providing quality healthcare and service to all patients. In order to continue in this mission, it is essential that payment be received for services provided. As a courtesy to patients and their families, CGH Medical Center submits medical claims to any insurance company according to the guidelines listed here. To do this efficiently, it is important that insurance information be presented at the time of service. An itemized bill for services by CGH Medical Center will be sent upon request of the patient and/or the responsible party. Patients and/or the responsible party (sometimes called the "guarantor") will receive a monthly statement which explains any activity occurring since the last statement.
Patient Responsibilities
Payment Responsibility & Prior Authorization
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, RRHI reserves the right to make payment the direct responsibility of the
patient or responsible party.
Medicare -
Medicaid - Medicaid billings are submitted on behalf of the patient. The patient will be promptly notified of any anticipated liability. A current copy of the patient's Medicaid card must be presented at each time of service.
Other Insurance
CGH Medical Center will bill up to two insurance companies if presented with insurance information and assignment of benefits at the time of service. All balances not paid after 30 additional days will become the responsibility of the patient.
Verification that the service is the result of a work related injury will be necessary before a claim is filed on behalf of the patient. Charges for hospital services incurred as a result of a work related injury will be handled in accordance with the Illinois Worker's compensation reform which became effective for dates of service on or after July 20, 2005 (Public Act 94-0277). All claims with dates of service prior to July 20, 2005 shall be handled as stated in the insurance billing section of this policy. All claims submitted with a date of service on or after February 1, 2006 will be paid per the established fee schedule. If only a portion of the bill or none of the bill is paid by the employer, CGH will seek payment from the patient for the appropriate patient due amount. On partially paid claims, CGH may bill the patient the fee schedule payment that would have been received from the employer. On denied claims, CGH may bill the patient the actual charges for services rendered. Upon the patient informing CGH Medical Center that there is an application filed with the Commission to resolve a disputed payment or a disputed denial of services, CGH will cease any and all efforts to collect payment for said services. In disputed cases, CGH Medical Center may mail the patient a reminder notice of the account. The reminder notice will state that the patient need not pay for the services until such time that CGH is permitted to resume collection efforts under this Act. The reminder notice may request that the patient furnish the provider with information about the arbitration. If the patient fails to respond to such request for information within 90 days of the date of the reminder, CGH Medical Center will resume any and all efforts to collect payment from the patient. Employers must pay clean claims within 60 days of receipt and a late payment is subject to a 1% per month interest. In certain instances, as deemed necessary by the patient account representative, CGH Medical Center may partner with MRA (Medical Reimbursements of America) for account balance resolution. MRA will assist CGH Medical Center in contacting the guarantor, attorney, and/or insurance companies to attempt to resolve the account balance.
If a patient receives treatment as a result of a vehicle accident or public liability, the hospital must hold the patient personally responsible for the hospital bills. Many such cases are difficult to settle and require many months before resolution, placing the hospital in financial hardship. When insurance money is sent direct to the patient/guarantor, CGH Medical Center considers the account as self-pay and balance is due. CGH Medical Center will file a lien in cases when the liability insurance information is provided. However, this does not release the patient from being responsible for the balance due. In certain instances, as deemed necessary by the patient account representative, CGH Medical Center may partner with MRA (Medical Reimbursements of America) for account balance resolution. MRA will assist CGH Medical Center in contacting the guarantor, attorney, and/or insurance companies to attempt to resolve the account balance.
When a Patient Owes a Balance
It is expected that all guarantors make "good faith" efforts to pay any balance
due the physician. CGH Medical Center will work with you to establish a reasonable
settlement of all balances that are the guarantor's responsibility. An account
is considered delinquent when:
- No payment agreements have been made within 30 days of final insurance payment (or final billing for self-pay accounts)
- There is no response to letters or phone calls
- A required "Financial Assistance Application" form and/or supporting documentation is not completed
- Terms of established hospital financing arrangements are not met
- No payments or short payments for 2 consecutive months on an established payment plan
All patients will receive one final notice and a grace period of 10 working days to forward any required payment. Disputed balances will be subject to further review by Patient Accounts before further collection efforts are pursued. In those cases where Patient Accounts have exhausted all reasonable efforts to collect the balances due CGH Medical Center, the account will be referred to an attorney for legal action or to a state-licensed agency for follow-up and collection. The cost to collect the account will be added to the original balance owed. CGH Medical Center has full-time personnel available to assist the guarantor in establishing financial arrangements to meet the needs of the patient and CGH Medical Center. For payment arrangements, please call (815) 625-0400 ext. 4428, ext. 4423, or ext. 5706.
CGH Medical Center has established the following guidelines for payment of guarantor balances:
$0-$500 ---- paid in full within 6 months
$500-above ---- paid in full within 1 year
To assist the guarantor in meeting his/her obligations, CGH Medical Center provides the following programs:
Automatic Debit Program
CGH Medical Center offers the convenience of automatically debiting your checking or savings account
for your monthly hospital payment. Please contact 625-0400 ext 4423, ext. 4428
or ext. 5706 for more information.
Pre-Approved Loan Program –
Click here to download the flyer. A Spanish version is also available. CGH Medical Center has partnered with Sauk Valley
Bank to offer a pre-approved loan to pay for your hospital bills. Please call
625-0400 ext. 4428, ext. 4423, or ext. 5706 for more information, or download
the flyer above. You may also download the loan application.
Credit Cards
CGH Medical Center will honor VISA, MASTERCARD or DISCOVER cards for the payment of accounts. These
payments will be accepted either by phone, in person or by mail.
Public Assistance
CGH Medical Center is available to actively assist you in completing the necessary
application forms to determine your eligibility for public assistance. Please
contact 625.0400 x2420.
All Kids - www.allkidscovered.com
Send your completed application to CGH Medical Center
ATTN: Patient Accounts
CGH Medical Center recognizes that there are occasions when a patient will not be able to pay a medical bill. Since obtaining care at CGH is not dependent on one's ability to pay, CGH expects the patient to document and qualify for charity or "free" care. The patient or responsible party must provide the following information in order for CGH to determine the appropriate amount of charity 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
- Copy of checking/savings statements for last 3 months
Consideration for charity is based on the patient's and/or responsible party's financial status in comparison with the Community Services Administration Guidelines. These guidelines are published in the Federal Register and are updated each spring. A sliding scale based upon family size and total family income extending to 300% of the Federal Poverty Guideline is utilized to determine eligibility. Applicants that do not qualify for charity care may be extended a self-pay discount of up to 25% of the total account balance. More information on this program is available by contacting us at (815) 625-0400 ext. 2420, or download our Charity Assistance Packet.
7 a.m. to 4:30 p.m. Monday - Friday
Sterling, IL 61081
(815) 625-6065 or (800) 404-0211



