Welcome to CGH Patient Accounts
Open 7:30 a.m. - 4:30 p.m.
Monday - Friday
1813 2nd Avenue
Sterling, IL 61081
Ph: (815) 625-6065
Toll-free: (800) 404-0211
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.
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, CGH Medical Center reserves the right to make payment the direct responsibility of the patient or responsible party.
Insurance Payment Guidelines
Medicare - CGH Medical Center is a certified Medicare provider. When secondary insurance policy information is presented at the time of service, Patient Accounts will submit one supplemental insurance claim for deductibles or coinsurance. This supplemental billing can only be completed after Medicare payment has been received and cannot be done by CGH Medical Center unless complete and accurate information is received at the time of service. While Medicare must be allowed as much time as needed to process a claim, supplemental insurances will have up to 30 days before the outstanding balance is determined to be a patient responsibility.
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.
Workers Compensation - 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.
Accidents and Injuries - 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.
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 have been made
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. 5680.
CGH Medical Center has established the following guidelines for payment of guarantor balances:
Minimum Monthly Payments on Patient Due Balances
$100 to $500 ---- $20 or 10%
$500 to $1,000 ---- $50 or 8.5%
$1,000 to $2,000 ---- $85 or 5%
$2,000 to $5,000 ---- $100 or 4.5%
over $5,000 ----- 4.2% or convert to loan
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 (815) 625-0400, ext. 5686 for more information.
Pre-Approved Loan Program - Click here to download the flier. 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 (815) 625-0400, ext. 5228 for more information, or download the flier 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 (815) 625-0400, ext. 5772.
All Kids (www.allkidscovered.com) - If you have a child under the age of 19, he or she may be eligible for the state funded All Kids program. Please contact (815) 625-0400, ext. 5772 or refer to the All Kids Income Standards and Cost Sharing Chart to see if your child is eligible for this program. Applications are available on the State of Illinois website in English or Spanish. Send your completed application to:
CGH Medical Center
100 E. LeFevre Road
Sterling, IL 61081
ATTN: Patient Accounts
Charity Care (Guidelines) - 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 three 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. 4620, or download our Charity Assistance Packet.
Thank you for choosing CGH Medical Center for your health care needs.