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Logan Health Shelby

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Billing & Payments

Marcia Heydon, Manager: (406) 434-3205

At Logan Health Shelby we understand that the healthcare bills you receive may be confusing. Below is information, including phone numbers for questions on the types of bills you may receive depending upon the service that was provided.

Logan Health Shelby has the philosophy of working for you in times of health care needs and with you when payment is due. Medical bills are not usually expected and come during times of sudden illness. It is important to communicate early with the hospital to ensure receipt of insurance information and payment arrangement options. We offer to help with insurance, payment arrangements, and credit card payments. These are easily arranged through the business office at (406) 434-3245 or email us here.

Other questions
  • For questions concerning hospital collection procedures, contact (406) 434-3245.
  • For questions concerning insurance payments pending, please contact (406) 434-3245.
  • For questions concerning pricing information, please contact (406) 434-3279.

Pricing Transparency
We are available to help you with your questions and concerns on any costs associated to your health care. Staff is available at 406-434-3279 to answer any questions.

You can download the complete price list for services. This is a current listing as of the time of posting, however, charges are subject to change.

Open the price transparency tool

Financial Assistance Policy

POLICY PURPOSE
Logan Health - Shelby, a not-for-profit community hospital, will not discriminate in providing medically necessary services to those in need regardless of their ability to pay. Determination of eligibility of a patient for Financial Assistance shall be applied regardless of the source of referral and without discrimination as to race, color, creed, national origin, age, handicap status, or marital status.  Patients deemed unable to pay will be eligible to receive Financial Assistance. Logan Health - Shelby will work to identify candidates for Financial Assistance based upon information submitted by the patient or patient’s representative and will provide Financial Assistance for those meeting the criteria of this policy. The patient is ultimately responsible to fulfill their financial obligation to Logan Health - Shelby and is not granted Financial Assistance until the application has been completed and approved. 
 
The Financial Assistance Policy must be approved by the Logan Health - Shelby Board of Trustees. This policy outlines the criteria to be used to determine a patient’s eligibility for the Financial Assistance Program.

POLICY
Definition:
Financial Assistance shall be defined as the patient’s demonstrated inability to pay, whereas, bad debt results from the unwillingness of the patient to pay.
Methods for Applying for Financial Assistance Program:
 
  1. In person at Logan Health - Shelby Business Office
  2. Via the Hospital’s website at logan.org/shelby
Measures for Publicizing Financial Assistance Program:
 
Logan Health - Shelby will advise patients and their families of Financial Assistance Program through the following means:
 
  1. Direct patient contact, in person, or by phone.
  2. Financial Assistance Program will be posted in each registration area, Emergency Department, and other waiting areas.
  3. Financial Assistance Program will be printed on applicable letters and statements.
  4. Posted on the hospital’s website at logan.org/shelby.   
  5. Financial Assistance Program will be posted annually on our social media, such as our website.
 Presumptively Eligible
A patient who has not submitted a completed Application for Financial Assistance, but who nonetheless is subject to one or more of the following criteria:
 
                1.   Homeless
                2.   Mentally incapacitated with no one to act on his or her behalf
                3.   Medicaid eligible, but in another state or not on the date of service
                4.   Enrolled in one or more governmental programs for low-income individuals having  eligibility criteria at or below 200% of the Federal Poverty Guidelines
 
Procedure for Determining Eligibility:
A request for a Financial Assistance application may be made by any person who could reasonably be expected to act for the patient, has a reasonable basis to believe that the person may qualify for uncompensated services, and can provide the information required to establish eligibility. Logan Health - Shelby requires that Power of Attorney documentation and/or a release of financial information be on file.
 
Eligibility Criteria:
Eligibility for Financial Assistance does not exist where an individual has, or can qualify, for other third-party coverage (Group or individual medical insurance plans; Workers Compensation plans; Medicaid, State, or County Medical programs; and other state, federal, or military programs). If an individual is not currently covered by a third-party, he/she may choose to apply for Medicaid or sign the attached attestation statement included in the Financial Assistance Program application. Logan Health – Shelby personnel will assist individuals to apply for Medicaid or other available programs. In the event that third-party coverage is discovered at a later date, any Financial Assistance write off will be reversed and third-party insurance will be filed.
 
Elective procedures are not eligible for financial assistance.
 
The patient, or representative, must fill out an application for Financial Assistance prior to being deemed eligible. The application shall be submitted with proof of income to be verified by previous year’s tax return, three previous months’ bank statements, and three previous months pay stubs. If the individual is unemployed and not collecting unemployment, an unemployment statement is to be provided. The applicant must sign a release form for all items not verified for Logan Health – Shelby to verify income. 
 
Eligibility is entirely determined based on gross income.  The applicant's family income must be at or below 200% of the Federal HHS poverty guidelines. The HHS poverty guidelines are published each year in the Federal Register and shall be published where the availability of the Financial Assistance Policy is published. A person can qualify by having income for a twelve month period, or the most recent three months at or below the guidelines. If an individual qualifies for Financial Assistance by meeting the three month criteria, that person's income for the applicable three months will be annualized for the purposes of this calculation. If an individual is normally employed seasonally, their yearly income shall be used for making this determination. Applicants with no insurance coverage that have been determined at or below 200 % of the federal poverty guidelines will receive a 100% write-off.
 
The amount of Financial Hardship Assistance per patient shall be determined as follows:
 
PERCENT AT OR BELOW FPG                               PERCENT OF WRITE OFF
100%                                                                                                        100%
125%                                                                                                          80%
150%                                                                                                           60%
175%                                                                                                          40%
200%                                                                                                           20%  (at least AGB variance)
 
Amounts Generally Billed (AGB):
 
The amounts generally billed for emergency or other medically necessary care to individuals who have insurance covering such care after discounts have been applied per the individual’s insurance contract. Logan Health - Shelby calculates the AGB pursuant to the look-back method, as described by IRC Section 1.501(r)-5. The look-back method is based on actual past claims paid to the hospital facility by Medicare Fee-for-Service along with all private health insurers paying claims to the hospital facility. The amounts billed for emergency and other medically necessary medical services will not be more than the AGB to individuals with insurance covering such care. The AGB percentage will be reviewed and updated annually by the 120th day after the 12-month period the hospital facility used in calculating the AGB percentage, which is October 1st for Logan Health – Shelby. The amount Generally Billed (AGB) is currently 5%.
 
Logan Health - Shelby adopts the U. S. Census Bureau's definition of family household for this policy.  The applicant must be financially responsible for family members included on the application (i.e. listed on tax return).
 
All medically necessary services will qualify for the Financial Assistance Program. Individuals can apply at the time of service. 
 
Charges not generated by this facility that are not eligible include:
 
  1. Clinic pathology charges.
  2. Reference laboratory charges.
  3. Consulting radiology charges (i.e. MRI, CT, Ultrasound, etc.).
  4. Specialty care delivered by consultants (Speech, Occupational)
 
If an individual gives the facility a payment before applying for Financial Assistance, that amount may be refunded to the patient if it is determined they are eligible for 100% write-off of charges.
 
Patients denied Financial Assistance will be notified by mail informing them of the reason for denial. Patients who are approved Financial Assistance shall be notified by mail stating the qualifying discount.  Failure to make payment will result in the remainder of the patient account being sent to a third-party collection agency and the Financial Assistance application void.
 
Logan Health - Shelby’s business office will keep a log of Financial Assistance Policy provided each fiscal year, along with all applications, of those approved and denied. Account notes will be maintained as well.
 
Patient Collections Practices:
 
  1. Patient will continue to receive statements for 120 days
  2. Notice to patient after 90 days informing that in 30 days account will be sent to collections
  3. Extraordinary collection actions (ECA’s) start on day 121
  4. Time frame for Application Period (240 days)
  5. ECA’s will be suspended with request for financial assistance up to 240 days of the application period until eligibility is determined
Billing Patients that do not qualify for the Financial Assistance Program:
 
Patients are billed full charges if they do not apply for the Financial Assistance Program. A “Self-pay discount” of 30% will be offered to uninsured patients who pay visit in full within 30 days of first statement, or 20% when payment arrangements are made in advance and balance is paid in full within 6 months of visit.
 
Patients not qualifying for the Financial Assistance Program may apply for financial hardship. The unpaid balance after third party payments for patients qualifying for Financial Hardship will be discounted. Patient Financial Services, Finance, or the President, will determine that full payment may cause social and financial hardship so as to significantly harm the patient or the family unit.

  Financial Assistance Application