Dedicated Assistance for Billing and Financial Needs
At HaysMed, we know that financial concerns can add to the stress of any medical condition, so our business office at HaysMed is here to serve you as effectively and efficiently as possible. It is our goal to assist you in every way we can.
To help you understand how your hospital billing will occur, these are the steps to expect:
- A summary bill is mailed for each account.
- After all insurance has paid on an account, payment in full is requested. If you feel your insurance company has not paid in accordance with your health plan, please contact your insurance company before calling HaysMed.
- After you have contacted your insurance company and understand what the insurance will pay on your account, if you are not able to pay the balance of your account in full upon receipt of your first statement, please call us at 785-623-5100.
When calling HaysMed 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
Payment Methods
Payments may be made by cash, personal check, or money order. Visa, Mastercard, Discover and American Express are accepted. After hours payments may be placed in the dropboxes located outside Hospital Entrances B and C.
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 self-pay discount is 67% for hospital services and 50% for physician services. If our information is not complete, and you do have insurance, please call 785-623-5100 to advise us.
Understanding The Cost of Care
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 HaysMed and would like to discuss an estimate for care, we encourage you to call the patient financial customer service center at 785-623-5100 Monday through Friday between the hours of 8:30 a.m. and 4:30 p.m. A trained counselor will answer your questions and make sure you understand the most realistic costs and payment payment options associated with your treatment, procedure or care – so you can focus on your health.
Price Transparency
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 HaysMed, we believe costs should be transparent.
We support helping our patients make informed decisions, which is why HaysMed’s 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.
The Centers for Medicare and Medicaid Services (CMS) have required all hospitals to make available a Charge Description Master (CDM). The CDM is a comprehensive listing of individual procedures, services and items billable to a hospital patient or a patient’s health insurance provider.
While this document outlines standard base charges, these are not necessarily charges a patient will see or pay. 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. In compliance with these requirements, as well as our commitment to provide our patients with full information about costs and charges, we make a practice of sharing our CDM or price transparency file.*
In addition, 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 – because they vary based on insurance plans.
If you have any questions about our CDM, our list of services and costs, or your specific costs, you may call us at 785-623-5100.
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 785-623-5100.
Insurance Plans Accepted
We contract with most major insurance companies listed in our area. However, please contact your insurance company first to see if we are in network.
If you have any other questions about insurance coverage for your care at HaysMed, you may call us at 785-623-5100.
Patient Rights and Responsibilities
The basic rights of Patients, including neonates, adolescents and/or guardians, for independence of expression, decision, actions, and concern of personal dignity and human relationships shall be respected and observed by all hospital staff. Reasonable and responsible behavior on the parts of Patients, their Relatives, and Friends is expected at all times.
Patient Rights
HaysMed and the medical staff have adopted the following statement of patient rights. This list shall include but not be limited to the patient’s right to:
- Receive a written statement of his/her rights as a patient in advance of, or when discontinuing, the provision of care. The patient may appoint a representative to receive this information should he/she so desire;
- Exercise these rights without regard to sex or cultural, economic, educational or religious background or the source of payment for care;
- Considerate and respectful care, provided in a safe and secure environment, free from all forms of abuse or harassment;
- Remain free from seclusion or restraints of any form that are not medically necessary and are used as a means of coercion, discipline, convenience, or retaliation by staff;
- Be provided with the name of the physician who has primary responsibility for coordinating his/her care and the names and professional relationships of other physicians and health care providers who will see him/her;
- Receive information from his/her physician about his/her illness, his/her course of treatment and his/her prospects for recovery in terms that he/she can understand;
- Receive as much information about any proposed treatment or procedure as he/she may need in order to give informed consent or to refuse the course of treatment. Except in emergencies, this
- information shall include a description of the procedure of treatment, the medically significant risks involved in the treatment, alternate course of treatment or non-treatment and the risks involved in each and to know the professional status of the person who will carry out the procedure or treatment;
- Participate in the development and implementation of his/her plan of care personally or by his/her representative, and actively participate in decisions regarding his/her medical care. To the extent permitted by law, this includes the right to request and /or refuse treatment;
- Formulate advance directives regarding his/her health care, and have hospital staff and practitioners who provide care in the hospital comply with these directives (to the extent provided by state laws and regulations);
- Send and/or receive visitors, mail, telephone calls or other forms of communication with restriction. If restrictions are required for therapeutic reasons, the patient and/or family will be informed of the rationale for restrictions.
- Have his/her family representative, and/or personal physician notified promptly of his/her admission to the hospital;
- Be provided with full consideration of privacy concerning his/her medical care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. The patient has the right to be advised as to the reason for the presence of any individual involved in his/her health care.
- Confidential treatment of all communications and records pertaining to his/her care and his/her stay in the hospital. His/her written permission will be obtained before his/her medical records can be made available to anyone not directly concerned with his/her care;
- Access information contained in his/her medical record within a reasonable time frame (usually within 48 hours of request);
- Be provided with reasonable responses to any reasonable request he/she may make for service within the hospital’s capacity, it’s stated vision, and applicable law and regulations;
- Leave the hospital even against the advice of his/her physician;
- Expect reasonable continuity of care and to know in advance the time and location of appointment as well as the physician providing the care;
- Be advised of the hospital grievance process, should he/she wish to communicate a concern regarding the quality of the care he/she receives or if he/she feels determined the discharge date is premature. Notification of the grievance process includes: Whom to contact to file a grievance, and that he/she will be provided with a written notice of the grievance determination that contains the name of the hospital contact person, the steps taken on his/her behalf to investigate, the results of the grievance and the grievance completion date;
- Be advised if hospital/personal physician proposes to engage in or perform human experimentation affecting his/her care or treatment. The patient has the right to refuse to participate in such research projects;
- Be informed by his/her physician or a delegate of his/her physician of the continuing health care requirements following his/her discharge from the hospital;
- Be advised that with the patient’s permission, family members are encouraged to participate in care decisions;
- If the patient has the legal capacity to exercise his/her rights, the patient has the right to exclude any or all family members from participating in his/her care decisions;
- Examine and receive an explanation of his/her bill regardless of the source of payment
- Know which hospital rules and policies apply to his/her conduct while a patient;
- Have all patients’ rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient
- Be provided with information necessary to enable him/her to make treatment decisions that reflect his/her wishes and that they will be supported by hospital personnel;
- Have clinical decisions concerning his/her care to be based solely on identified health care needs, without regard to the cost of the services or treatment or the patient’s ability to pay;
- To optimize comfort and dignity through treatment as desired by the patient or surrogate decision maker and acknowledgement of the psychosocial and spiritual concerns of the patients and family regarding dying and the expression of grief by the patient and family;
- Participate in the consideration of ethical issues by the HaysMed Bioethics Committee that arise in the care of the patient;
- Be transferred to another facility when medically permissible;
- Arrange payment of the portion of his/her bill not paid by third party coverage;
- Has the right to access protective services;
- Except appropriate assessment and management of pain
- Be advised of pastoral care/spiritual services
Patient Responsibilities
In addition to these rights, a patient has certain responsibilities. These responsibilities should be presented to the patient in the spirit of mutual trust and respect. The patient has the responsibility to:
- Provide accurate and complete information concerning his/her present complaints, past illnesses and hospitalization, and other matters relating to his/her health
- Report unexpected changes in his/her condition to the responsible practitioner;
- Be responsible for making it known whether he/she clearly comprehends the course of his/her medical treatment and what is expected of him/her;
- Be responsible for keeping appointments and for notifying the hospital or physician when he/she is unable to do so;
- Be responsible for following hospital policies and procedures;
- Be responsible for being considerate of the rights of other patients and hospital personnel;
- Assist in the control of noise and the number of visitors;
- The patient is responsible for assuring that the financial obligations of his/her hospital care are fulfilled as promptly as possible;
- Inform hospital administration of any complaint or concern he/she may have regarding the delivery of quality of health care;
- If the patient has Advance Directives, it is the patient’s responsibility or that of his/her representative to present the Advance Directive to HaysMed staff.
Patient Financial Responsibilities
HaysMed is pleased to provide this information to help you understand the billing process. The patient or the guarantor is responsible for assuring that the financial obligations of his/her hospital care are fulfilled as promptly as possible. The following information is supplied to assist you in settling your accounts.
A summary bill is mailed to the person responsible for the bill (the guarantor) for each account, and if insured, a claim is submitted to your insurance company. After all insurance companies have paid, a statement requesting payment of the balance will be sent to the guarantor.
Payments may be made by cash, personal check, or money order. Visa, MasterCard and Discover are accepted. If you have health insurance and feel your insurance company has not paid in accordance with your health plan, please contact your insurance company before calling HaysMed. It is to your benefit to assist in the collection process from the insurance company, as unpaid bills may affect your credit standing.
When calling HaysMed, or your insurance company, with billing questions, please have as much of the following information available as possible:
- Patient Name
- Date of Service
- Account Number
- Explanation of benefits from your insurance
To reach one of our Patient Financial Services Representatives, please call the number provided on your statement, or call 785-623-5100.
Financial Assistance Application and Policy Summary
Qualifications for Financial Assistance
Here at HaysMed, we realize that financial concerns can add to the stress of any medical situation. Financial assistance will be made available to any eligible patient. Each case is handled individually, based on the following eligibility guidelines:
- Applicant must agree to participate in a review for qualification for coverage through any applicable public program such as Medicaid or KanCare
- Payment from all other sources must be exhausted
- Assistance is applied only to the self-pay portions of a patient’s bill
- Patient must reside in our service area and meet residency requirements
- Financial need is based on income guidelines established by the federal government
- Financial assistance will be provided only for those procedures considered to be medically necessary
- Applicant must provide copies of income tax return and prior three months pay stubs (additional information may be requested)
- Applicant must complete HaysMed’s Financial Assistance Application form
- For HaysMed Family Medicine, Medical Specialists, the Center for Women’s Health, and the HaysMed Multispecialty Clinic in Dodge City eligibility is based only on income and family size
If you feel you may qualify for financial assistance, or if you have any questions, please contact one of our Financial Counselors at 785-623-5100.
In compliance with section 501(r)(6) of the Internal Revenue Code (IRC), the hospital will inform their patient(s)/guarantor(s) of the financial assistance policy (FAP) and will make reasonable efforts to determine eligibility for financial assistance.
The patient(s)/guarantor(s) 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 the financial assistance application and submitting it, along with other required documents, to HaysMed, 2220 Canterbury, Hays, KS 67601.
- An application may be requested from the Registration Department at HaysMed or by calling HaysMed’s Customer Service Department at 785-623-5100.
- The completed application, along with the supporting documents listed on the application, may be sent to HaysMed at 2220 Canterbury Drive (or P.O. Box 8110) Hays, KS 67601, or it may be delivered to the Registration Department at HaysMed at 2220 Canterbury Drive, Hays, KS.
- 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 or guarantor’s credit rating.
Eligibility Criteria
- Applicants 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 above. Additionally, the policy can be viewed on public display at the hospital or on the hospital’s website.
- 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 Guidelines (FPG), as follows:
- 100% discount if income is 0% to 130% of FPG
- 75% discount if income is 131% to 175% of FPG
- 50% discount if income is 176% to 250% of FPG
- 25% discount if income is 251% to 400% of FPG
- Catastrophic medical expenses will also be a factor in determining eligibility for financial assistance.
- After the application has been reviewed, a determination of eligibility, or non-eligibility, will be made and the applicant will be notified of the decision.
- In the event of non-payment of any amount determined to be the responsibility of the patient/guarantor, and in 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 or the initiation of legal proceedings.
For additional information on financial assistance or to ask questions,you may call HaysMed at 785-623-5100 or visit in person at 2220 Canterbury Drive, Hays, Kansas.
Charity Care
HaysMed provides comprehensive healthcare to all people, including those in financial need.
About 10 percent of the population in Kansas have no health insurance. A large proportion of the uninsured is made up of working families who are self employed or work for small businesses that do not provide health insurance as a benefit.
HaysMed provides a safety net for vulnerable populations who have no health insurance. The cost of providing charity care and the unpaid cost of serving Medicaid patients are counted as a community benefit.
Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs in such a way as to improve residents’ access to health care services, enhance the health of the community, advance medical or health knowledge, or relieve/reduce the burden on government or other community efforts. HaysMed’s community benefits include education, charity care, subsidized health services, community health improvement activities and more.
Quality care for Kansans
At HaysMed and across our western Kansas alliance, we bring a shared commitment to high-quality care, outcomes and experiences. Our mission is deeply rooted in our role as a resource and partner for every patient and every community we serve.