Billing and Financial

It is always our goal to provide comprehensive information and assistance with billing and financial matters related to your care with us.

Dedicated Assistance for Billing and Financial Needs

We know that financial concerns can add to the stress of any medical need, so at Pawnee Valley Community Hospital, we want you to have a full understanding of our billing and financial policies and procedures.

A summary bill is mailed for each account. After all insurance has paid on an account, payment in full is requested. Payments may be made by cash, personal check, or money order. We currently accept all major credit cards (American Express, Visa, MasterCard, Discover), as well as debit cards and direct withdrawals from checking and savings accounts.

If you are not able to pay the balance of your account in full, upon receipt of your first statement, we encourage you to call the Patient Financial Customer Service Center Monday through Friday, between the hours of 8:30 am and 4:30 pm, at 785-623-5100.

If you feel your insurance company has not paid in accordance with your health plan, please contact your insurance company before reaching out to us.

When calling our office or your insurance company with billing questions, have as much of the following information available as possible:

Patient Name
Date of Service
Account Number
Explanation of benefits from your insurance

Pawnee Valley Community Hospital billing is managed by HaysMed, and your calls will be routed to the HaysMed billing office.

Understanding the Cost of Care

Cost is only one factor consumers should review when making healthcare decisions. Outcomes, quality, safety data, and patient experience should also be considered – but at Pawnee Valley Community Hospital, we believe costs should be transparent.

We support helping our patients make informed decisions, which is why our Patient Financial Customer Service Center provides individualized assistance in determining the actual cost of care. Understanding your costs for care and procedures can be complicated, but we can help by providing an estimate for what you may be required to pay. Learn more about price transparency at Pawnee Valley Community Hospital.

We are here to help you make an informed decision about your healthcare, based on your specific needs and care plan. If you are a patient or caregiver for a patient at Pawnee Valley Community Hospital and would like to discuss an estimate for care, we encourage you to call the Patient Financial Customer Service Center Monday through Friday, between the hours of 8:30 am and 4:30 pm, at 785-623-5255. A trained counselor will answer your questions and make sure you understand the most realistic cost estimate associated with your care – so you can focus on your health.

Self-Pay Discount Policy

A reduction will be applied to the bill of non-insured patients prior to the bill being sent to the guarantor (person responsible for the bill). The discount is 60% for hospital services and 30% for physician clinic services. If our information is not complete, and you do have insurance, please call 785-623-5100 to advise us.

Understanding Our Financial Assistance Policies and Application Process

In compliance with section 501(r)(6) of the Internal Revenue Code (IRC), the hospital will inform patient(s)/guarantor(s) of the financial assistance policy (FAP) and will make reasonable efforts to determine the eligibility of patient(s)/guarantor(s) for financial assistance. The patient(s)/guarantor(s) who apply for financial assistance will be notified in writing of the determination.

If the determination is made that an individual is eligible for assistance, the hospital will reverse, when possible, adverse results of any collection efforts and will refund any overpaid amounts to the individual. The hospital will also issue a new billing statement which represents the amount generally billed (AGB) to individuals with insurance. This amount will be calculated using the “look-back” method, based on actual past claims paid to the hospital by Medicare and by other private insurers.

Application Process

A patient/guarantor may apply for financial assistance by completing our Financial Assistance Application (English) | Financial Assistance Application (Spanish) and mailing it, along with other required documents listed on the application, to: HaysMed at PO Box 8110 Hays, KS 67601.
If you wish to pick up a hard copy of the application or have an application mailed to you, you may make a request at the Registration Departments at either location shown above or call the HaysMed Customer Service Department at 785-623-5100.
In the event of non-payment of any amount determined to be the responsibility of the patient/guarantor and the absence of an application for assistance, the hospital may refer the account(s) to an outside collection agency. Such action may result in an adverse entry on the patient’s/guarantor’s credit rating.

Eligibility Criteria

Applicant will be screened for eligibility for any third party payor sources, such as Medicaid, and payment from any such source(s) must be exhausted before applicant will be eligible for hospital financial assistance.
The applicant must also meet other eligibility criteria which are included in the full financial assistance policy. This policy may be requested and/or viewed by accessing the addresses, locations, or telephone numbers shown in section A (above). Additionally, the policy can be viewed on public display at the hospitals or on the hospitals’ websites. (see A., 3 above)
Once the applicant is deemed eligible for assistance, the actual level of assistance will be determined, in part, by comparing the applicant’s family income to the Federal Poverty Level (FPL), as follows:
- 100% discount if income is 0% to 130% of FPL

(FREE PET scans have to qualify in this bracket) *yearly gross/FPL

- 75% discount if income is 131% to 175% of FPL
- 50% discount if income is 176% to 250% of FPL
- 30% discount if income is 251% to 400% of FPL
Catastrophic medical expenses will also be a factor in determining eligibility for financial assistance

For additional information on financial assistance or to ask questions, inquirers may call HaysMed at 785-623-5100 or visit in person at 2220 Canterbury Rd, Hays, KS.

The Centers for Medicare and Medicaid Services (CMS) have required all hospitals to make available a Charge Description Master (CDM). This CDM is a comprehensive listing of individual procedures, services and items billable to a hospital patient or a patient’s health insurance provider, but it is not reflective of what a patient actually pays.

In compliance with this requirement, as well as to offer our patients more information about costs and charges, we share this price transparency file. Cost is only one factor consumers should review when making healthcare decisions. Outcomes, quality, safety data, and patient experience should also be considered – but at Pawnee Valley Community Hospital, we believe costs should be transparent.

In addition to our CDM, we have provided a list, as required by CMS, of some of the most common services and associated costs. Like the CDM and other files, it is important to remember these do not necessarily reflect the exact charges a patient will see, depending on insurance plans and other factors.

We support helping patients make informed decisions, which is why we offer a Patient Financial Customer Service Center to provide individualized assistance in determining the actual cost of care.

No Surprises Act

Effective Jan. 1, 2022, the federal No Surprises Act became law, to help patients understand health care costs in advance of care – to minimize unexpected medical bills. The No Surprises Act protects patients covered under individual or group health insurance plans from surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.

Under the law, patients without insurance are entitled to a good-faith estimate of potential costs for medical services when scheduled at least three days in advance. Individuals with Medicare, Medicare Advantage, Medicaid, and certain other federal insurance plans are not covered under the No Surprises Act because these federal insurance programs already have existing protections in place to minimize unexpected, high cost medical bills.

If you have any questions, please contact our billing office at 785-623-5255.

Support and assistance

Understanding your costs for care and procedures can be complicated. We can help with an estimate for what you may pay. It is important to understand the following issues:

While this document outlines standard base charges, these are not necessarily charges a patient will see.
Every patient is unique and actual patient payment is highly dependent upon a combination of factors.
Even for similar procedures at the same facility, what a patient actually pays may differ based on their insurance plan and other factors.
Cost is only one factor consumers should review when making healthcare decisions. Outcomes, quality/safety data and experiences should also be considered.

To view the Pawnee Valley Community Hospital CDM, please click the link below:

PRICE TRANSPARENCY FILE

If you have any questions about our CDM or your specific costs, you may call us at 785-623-5255.

Additional files to be posted as quickly as possible.