To apply for financial assistance, fill out the Financial Aid Application and provide the required documentation, including proof of annual income and assets, such as pay stubs, tax documents, and bank statements. A committee reviews financial assistance applications and usually makes decisions within 30 days.

To get started on your application:

• Read the Financial Aid Summary
• Read the Financial Aid Policy
• Download the Financial Aid Checklist & Application

To speak with an MRH Financial Navigator, call 435-719-3536.

The deadline to apply for MRH financial assistance is 240 days after the date of your first billing statement.

Government-Sponsored Medical Assistance Programs

Moab Regional Hospital has a State of Utah Eligibility Specialist to assist with questions regarding government medical/financial aid programs, such as CHIP, PCN, UPP, Medicaid, Private Health Insurance, and APTC. To schedule an appointment to speak with our Medicaid Outreach specialist, call Tammie Berrie at 435-719-3608.

Available for patients who qualify. You must fill out and submit a Medicaid Medical Assistance Application to determine eligibility.

Pick up a Medicaid Application in our Business Office or:

• Download and Print English Application 
• Apply for Medicaid online

El Hospital Regional de Moab es un hospital no gubernamental sin fines de lucro 501(c)3. Como parte de nuestro compromiso con la comunidad, ofrecemos asistencia financiera a todos aquellos pacientes que califiquen. Si sus facturas hospitalarias representan un problema económico para usted, lo animamos a presentar su aplicación. La asistencia financiera se determina en base a una escala de ingresos y al tamaño de la familia. Las personas que cuentan con seguro médico también podrían ser elegibles para recibir asistencia financiera para ayudarlos a cubrir los copagos y deducibles. Las aplicaciones para recibir asistencia financiera son revisadas por un comité y generalmente se deciden en un plazo no mayor a 30 días.

Para aplicar por asistencia financiera, llene la aplicación y entregue los documentos requeridos incluyendo una prueba de sus ingresos anuales y bienes, tales como talones de cheques, documentos del pago de impuestos y/o extractos del banco.

Para comenzar su aplicación:

• Lea el resumen de Ayuda Financiera
• Descargue la Lista de Verificación y Aplicación de Ayuda Financiera

Para hablar con un navegador de Ayuda Financiera del MRH, llame al 435-719-3536.

La fecha límite para aplicar por ayuda financiera es 180 días después de la fecha de su primer estado de cuenta.

Programa de Ayuda Financiera auspiciado por el gobierno

Tenemos un especialista de elegibilidad del Estado de Utah en el hospital, dicho especialista lo puede ayudar a resolver todas las dudas y preguntas que pueda tener respecto a los programas de ayuda médica/financiera del gobierno tales como CHIP, PCN, UPP, Medicaid, Seguros de Salud Privados y APTC. Para hacer una cita con nuestro especialista de Medicaid, llame a Tammie Berrie al 435-719-3608.

Disponible para pacientes que califican. Para determinar si usted califica, debe llenar y entregar la Aplicación de Asistencia Médica Medicaid.

Puede recoger una copia de dicha aplicación en la oficina financiera del Hospital Regional de Moab o:

• Descargue e imprima la aplicación en español
• Aplique en línea

Moab Regional Hospital partners with third party providers for certain services, such as laboratory and imaging reads. In addition to your bill from Moab Regional Hospital, you will receive a bill directly from the third party provider. Services from these providers are billed separately from your hospital bill. You will not see these charges duplicated on your bill from Moab Regional Hospital.

• Mountain Land Physical Therapy
• Utah Imaging Associates
• Grand County EMS
• Quest Diagnostic
• Classic Lifeguard
• St. Mary's Community Outreach
• Visiting physicians at Moab Regional Medical Clinic

From the time you enter our hospital until the time your bill is paid in full, we believe you are in our care. The timeline below helps you understand what to expect in a typical case after you have received care at Moab Regional Hospital.

2 – 3 Days from Hospital Admission: Initial Charges

• Initial charges are posted to patient’s account.

7 Days from Hospital Admission: Itemized Breakdown

• If the patient has insurance, MRH will bill their insurance within approximately seven days after the visit.
• At this time, patient will receive an itemized listing of all procedures or treatments rendered. Although it looks similar to a bill, it is NOT a bill.

30 Days from Hospital Admission: First Billing Statement

• Typically, it takes approximately 30 days for MRH to collect payment from an insurance company.
• When we receive payment from the insurance company, MRH will send you a bill showing any remaining balance for which the patient (or named responsible party) is responsible.
• This bill is what we refer to as the “first statement.”
• MRH sends out patient bills in alphabetical order by last name: e.g., names beginning with “A” will go out earlier in the month, while names beginning with “Z” will go out later in the month.

After 90 Days (three billing cycles) the account becomes delinquent.

• You have 10 days from the date of the third billing statement to contact us and pay your bill. After 10 days, we may send your bill to our collection agency.

From the date of your first billing statement you have 120 days to apply for financial aid.

• If you are unable to pay your bill contact our office for financial aid information.

NOTICE OF RIGHT TO GOOD FAITH ESTIMATE

You have the right to receive a “Good Faith Estimate” that explains how much your medical care will cost.

Under the law, healthcare providers need to give PATIENTS WHO DO NOT HAVE INSURANCE or WHO ARE NOT USING INSURANCE an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical item or service. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, please visit www.cms.gov/nosurprises or call Moab Regional Hospital’s business office at, 435-719-3536. One of our Billing Specialists will be happy to assist you.

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

When you receive emergency care or are treated by an out-of-network provider at an in-network hospital, you are protected from balance billing.

WHAT IS “BALANCE BILLING” (sometimes called "Surprise Billing")?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be allowed to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

YOU ARE PROTECTED FROM BALANCE BILLING FOR:

EMERGENCY SERVICES
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

CERTAIN SERVICES AT AN IN-NETWORK HOSPITAL
When you get services from an in-network hospital, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you receive other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

WHEN BALANCE BILLING ISN’T ALLOWED, YOU HAVE THE FOLLOWING PROTECTIONS:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.

Your health plan generally must:

• Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

You are never required to give up your protections from balance billing. You are not required to get out-of-network care. You can choose a provider or facility in your plan’s network.

If you believe you’ve been wrongly billed, contact Moab Regional Hospital's billing office, 435-719-3536. One of our Billing Specialists will be happy to assist you. Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.

Insurance: A practice or arrangement by which an insurance company or government agency provides a guarantee of compensation for specified loss, damage, illness, or death in return for payment of a monthly or yearly premium. Insurance companies offer a variety of insurance plans, and therefore pay differently according to each individual plan.*

Co-Payment or Co-Pay: A fixed dollar amount that insured patient(s) pay directly to the provider when receiving medical care. Copays do not count toward your annual deductible or coinsurance. Co-pay amounts vary depending on each plan that may include but may not be limited to: Office Visits, Specialist Visits, ER Visits, and Pharmacy Needs.*

Deductible: A specified amount of money that the insured patient(s) must pay before your insurance company starts paying on claim(s). Deductibles do not count toward your co-insurance. Some insurance plans have minimal deductible while others have very high deductibles.*

Co-Insurance: The remaining portion of a claim in which both the insured patient(s) and their insurance company share responsibility, and this is often expressed as a percentage. Co-insurance applies only AFTER the deductible has been met. This should not be confused with Secondary Insurance. The co-insurance goes into effect after the deductible has been met. Amounts vary from plan to plan. For example, an 80%/20% split is co-insurance in which the insurance company pays 80% of the cost and the insured patient(s) pays the remaining 20%*

Co-Insurance Out-of-Pocket Maximum: If you have an insurance plan with a co-insurance out-of-pocket maximum, this means there is a limit on how much you will have to pay per year out of pocket. After you have paid the co-insurance maximum, the insurance company pays 100% of your covered medical expenses for the rest of the year (up to your plan’s annual maximum). This excludes your deductible and any co-pays.

* See your specific plan for details concerning amounts.

For any other questions, call 435-719-3536 to speak with a member of our Business Office.

Q: When will I receive my bill?

A: You will receive your first billing statement about 30 days after you became a patient.

Q: What if I have health insurance?

A: For insured patients, we will first bill the insurance agency. Once we receive payment from the insurance agency, we will deduct that payment from your balance due and send you your first billing statement. Coverage and deductibles vary; it is best to speak to your insurance agency directly with any questions regarding your specific coverage.

Q: When do I pay my co-payment and deductible?

A: For our non-insured or “cash pay” patients, we automatically give a 39% discount. If our patients pay their bill in full within first 30 days after the first billing statement, we give an additional 20% discount on their total bill. We strongly suggest that cash-pay patients who are struggling with financial hardship take advantage of the various payment plans and financial assistance programs we offer.

Q: How will I know my insurance company has been billed?

A: The total amount billed to your insurance company will be listed on any billing statements we send you. You should also be able to verify all payments with your insurance company directly.

Q: Do I have to pay a deposit?

A: Depending on the procedure and whether or not it requires preauthorization, you may be required to pay a portion of your bill at the time of service. The best way to find out if a particular procedure is covered it to speak with your insurance provider directly.

Q: What if I do not have insurance?

A: For our non-insured or “cash pay” patients, we automatically give a 39% discount. If our patients pay their bill in full within first 30 days after the first billing statement, we give an additional 20% discount on their total bill. We strongly suggest that cash-pay patients who are struggling with financial hardship take advantage of the various payment plans and financial assistance programs we offer.

Q: What if I am having trouble paying my bill in full?

A: For those who qualify, we offer financial assistance up to 100%. In order to request financial assistance from the hospital, you must fill out and return a Financial Aid Application. Applications are reviewed by a committee which will usually give a decision within 30 days.  We offer payment plans with no interest for 6 months, and longer term plans through MedSource.

Q: There is a problem with my bill. How do I file a complaint?

A: If there is a problem, we will review it and help resolve your questions. Call our Business Office at 435-719-3540 or send an email and we will resolve the issue as quickly as possible.