When you come to CGH Medical Center for care, we'll work with you to make paying your medical bill as quick and efficient as possible. Here's what you need to know about our insurance payment process, payment plans, billing services, and other vital payment information.
Medicare Insurance Benefits
CGH Medical Center is a certified Medicare provider. We can submit one supplemental insurance claim for your deductibles or co-insurance payments, but we can only submit that claim after we've received your Medicare payment.
In order to complete this process, we'll need complete and accurate insurance information at the time of service. Your supplemental insurance plan will have up to 30 days to pay the claim before it becomes your responsibility.
Medicaid Insurance Benefits
Please show your Medicaid card at the time of service. We'll submit your Medicaid claim on your behalf, and you'll be notified of your financial responsibility.
Workers Compensation Claims
Before we can use this form of payment, we'll need verification that the service is required due to a work-related injury.
We'll handle payments in accordance with the Illinois Workers' Compensation Commission rules (Public Act 94-0277). If none or only a portion of the bill is paid by the employer, we'll seek payment from the patient. On partially paid claims, we may follow the fee payment schedule that would have been received from the employer. On denied claims, we may bill the patient the actual charges for services rendered.
If you inform us that there has been an application filed with the Commission to resolve a disputed payment or a disputed denial of services, we will cease any and all efforts to collect payment for said services.
In disputed cases, we'll notify you by mail that you need not pay for the services until such time that CGH is permitted to resume collection efforts under this Act, and we may ask you to provide information about the arbitration. If you fail 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. Employers must pay clean claims within 60 days of receipt, and late payment is subject to 1-percent-per-month interest.
Payment for Claims due to Accidents and Injuries
If you come to CGH Medical Center for treatment for an injury caused by a vehicle accident or public liability, we must hold you personally responsible for the medical bills. Often, cases like this are difficult to settle, and they may take months to resolve. That wait puts the medical center in financial hardship.
When insurance money is sent directly to you, we consider the account a self-pay account and we consider the balance due.
If you provide insurance information when you arrive, we can file a claim for you, but this does not release you from your responsibility for the balance.
When Your Bill is Considered Overdue
We can send you an itemized bill for services on request, and we'll send an itemized statement that lists billing activity every month.
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 medical financing arrangements are not met.
- No payments or short payments for two consecutive months on an established payment plan have been made. Minimum monthly payments on balances are as follows:
- $100 to $500: $20 or 10 percent, whichever is higher.
- $500 to $1,000: $50 or 8.5 percent, whichever is higher.
- $1,000 to $2,000: $85 or 5 percent, whichever is higher.
- $2,000 to $5,000: $100 or 4.5 percent, whichever is higher.
- Over $5,000: 4.2 percent or convert to loan.
If you meet these conditions, you'll receive one final notice and a grace period of 10 working days.
If you dispute the balance, our Patient Accounts team will review the matter before performing more collection efforts.
In those cases where the Patient Accounts team has exhausted all reasonable efforts to collect the balances due to 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.
Medical Payment Plans
We have several options that can make paying your bills easy to do and hard to forget. We can set up automatic payment plans and pull your payments from your debit or credit account. Just contact us to find out more about that option.
We also offer a loan to pay for your medical bills. Contact us at 888.681.1746 for more information.
Help with Your Medical Bills
We can help you fill out the necessary paperwork to determine your eligibility for public assistance.
If you have a child younger than 19, he or she may be eligible for the state-funded All Kids program. Applications are available on the State of Illinois website in English or Spanish. Send your completed application to Patient Accounts, CGH Medical Center, 100 E. Le Fevre Road, Sterling, IL 61081.
Since obtaining care at CGH is not dependent on one's ability to pay, we offer a charitable program to help people who simply cannot afford to pay for care. You must provide the following information in order for CGH to determine the appropriate amount of help to apply to your 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.
We'll use that information to assess your case in accordance with the Community Services Administration Guidelines, which are published in the Federal Register and updated each spring.
If you don't qualify for charity care, you may be extended a self-pay discount of up to 25 percent of the total account balance. More information on this program is available by contacting us at 815.564.4620, downloading our Charity Assistance Packet in English or Spanish, or viewing our Financial Assistance Scale.
For questions regarding your CGH Main Clinic bill, please call 815-625-4790, ext. 3082
Patient Rights and Protections Against Surprise Medical Bills
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
Contact the Financial Services Team
Monday through Thursday: 7 a.m. to 7 p.m.
Friday: 7 a.m. to 5 p.m.
Saturday: 8 a.m. to noon
For Clinic Bill Questions
Please call 815-625-4790, ext. 3082