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Patient Billing Information
Thank you for choosing Maury Regional Hospital for your health care services. The following is important information about the billing process that we hope you find helpful. Should you have any questions, please contact Patient Accounts, Monday through Friday, from 8:00 a.m. until 4:30 p.m.
Your statement from Maury Regional Hospital may include services from the following locations: Maury Regional Hospital, Maury Regional Ambulatory Care Center, Lewis Ambulatory Care Center, Maury Regional Northside Medical Plaza, or for specimens referred to our laboratory.
You may also receive separate bills for services rendered by your physician, anesthesiologist, radiologist, pathologist, ambulance service or Emergency Department physician. These bills are not generated by Maury Regional Hospital; therefore, you should contact the approriate entity for inquiries.
The following information is applicable to Maury Regional Hospital patients only. If you have questions about your account or the charitable care policies at our affiliate facilities, please contact the appropriate facility at the number below:
Marshall Medical Center
931.359.6241, ext. 3352
Wayne Medical Center
931.722.2025, ext. 1104
Maury Regional Hospital Charitable Care, Prompt Payment, Uninsured/Underinsured Discount Policy
Maury Regional Hospital is committed to provide high quality patient care for services. This policy provides for treatment of uninsured and/or underinsured patients, who are non-elective and/or in a life-threatening condition or illness. Elective cases will be evaluated on a case-by-case basis. Maury Regional Hospital has guidelines for providing relief for patients who do not have the ability to pay medical bills incurred at MRH.
- In order to determine a patient’s eligibility, a financial assistance application must be completed.
- Representatives from Maury Regional Hospital will work with the patient or a member of the patient’s family through the entire financial assistance process.
- The Charitable Care Policy permits full or partial charity care discounts based on financial eligibility. Maury Regional Hospital utilizes the Federal Poverty Guidelines as published in the Federal Register to determine income levels.
- For assistance, please contact the Maury Regional Hospital Business Office at 931.380.4084.
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| Family Size |
100% |
150% |
175% |
200% |
Over 200% |
| 1 |
$0 - $10,400 |
$10,401 - $15,600 |
$15,601 - $18,200 |
$18,201 - $20,800 |
$20,801+ |
| 2 |
$0 - $14,000 |
$14,001 -$21,000 |
$21,001 - $24,500 |
$24,501 - $28,000 |
$28,001+ |
| 3 |
$0 - $17,600 |
$17,601 - $26,400 |
$26,401 - $30,800 |
$30,801 -$35,200 |
$35,201+ |
| 4 |
$0 - $21,200 |
$21,201 - $31,800 |
$31,801 - $37,100 |
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$42,401+ |
| 5 |
$0 - $24,800 |
$24,801 - $37,200 |
$37,201 - $43,400 |
$43,401 - $49,600 |
$49,601+ |
| 6 |
$0 - $28,400 |
$28,401 - $42,600 |
$42,601 -$49,700 |
-$49,701 - $56,800 |
$56,801+ |
| 7 |
$0 - $32,000 |
$32,001 - $48,000 |
$48,001 -$56,000 |
$56,001 -$64,000 |
$64,001+ |
| 8 |
$0 - $35,600 |
$35,601 - $53,400 |
$53,401 -$62,300 |
$62,301 -$71,200 |
$71,201+ |
| For each additional person add |
$3,600 |
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-- |
-- |
-- |
| Discount |
| Inpatient |
100% |
90% |
80% |
70% |
30% |
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|
|
|
|
|
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| Outpatient |
Patient will owe $50 for each outpatient visit |
Patient will owe $100 for each outpatient visit |
Patient will owe $150 for each outpatient visit |
Patient will owe $200 for each outpatient visit |
Patient will owe first $250 and will receive a 30% discount on remaining balance |
Note: These limitations are applicable to each date of service for each admission or procedure.
The following guidelines are to be used when a customer requests to set up a payment plan. Payment schedules shall not be less than the allowable maximum monthly schedule:
Amount Owed |
Minimum Payment |
Maximum Months |
$10 - $100 |
Payment in full |
N/A |
$101 - $500 |
$50 per month |
6 |
$501 - $1,000 |
$75 per month |
12 |
$1,001 - $5,000 |
$100 per month |
24 |
$5,001 - $7,500 |
$200 per month |
36 |
Above $7,500 |
To be determined |
N/A |
Note: In the event that collection efforts are unsuccessful, a collection agency may be utilized to assist in the collection of any patient or guarantor responsible balance. It is not the policy nor practice of Maury Regional Hospital to routinely and aggressively pursue collections through the legal system. Any collection agency under contract with Maury Regional Hospital shall not institute litigation with respect to any account without written authorization of the hospital.
Uninsured/Underinsured Policy:
“In accordance with TCA-68-11-262, Maury Regional Hospital is prohibited from requiring an uninsured patient to pay for services in an amount that exceeds one hundred and fifty percent (150%) of the average commercial health insurance reimbursement for the services provided.”
UNINSURED/UNDERINSURED patients will not be charged more than one hundred fifty percent (150%) of Maury Regional Hospital’s average commercial health insurance reimbursement for the services provided. Periodic internal audits will be conducted within the Finance Department of Maury Regional Hospital to ensure that MRH is in compliance with TCA-68-11-262.
Prompt Payment Discounts:
Uninsured patients, during normal contact with Business Office personnel, may be offered a charitable care application and/or a discount for the prompt payment of their account. Prompt pay discounts will be offered under the following guidelines:
Uninsured/Underinsured Patients*: 30% discount for payment in full within 10 business days of contact with the Maury Regional Hospital Business Office.
Insured Patients:
- 20% discount for payment in full of any balance over $1,000 if paid in full within 10 business days of contact with the Maury Regional Hospital Business Office.
- 10% discount for payment in full of any balance under $1,000 but over $200 if paid in full within 10 business days of contact with the Maury Regional Hospital Business Office.
- No discount for payment in full of any balance under $200 for insured patients.
*Maury Regional Hospital defines underinsured (for the purpose of prompt pay discounts) as any one (1) encounter in which a patient’s portion of the bill exceeds $3,500.
Thebusiness office manager and/or the associate director of finance must approve any discounts outside of this policy. If either of the above-listed personnel deem necessary, they may also require approval from the chief financial officer.
Effective Date: August 1, 2004
Updated: April 5, 2006
Instructions to determine eligibility for reduced payments or financial assistance
To determine if you are eligible for reduced payments or financial assistance, you must complete the financial assistance application and return it along with the following:
- Attach copies of any income received within the household. This would consist of two most recent pay stubs, two most recent and consecutive bank statements, social security checks, pension funds, support payments, etc.
- If no income, please submit a notarized letter from the individual(s) that provide you food and shelter.
- List amounts in checking, savings and CD accounts, IRAs, stocks and bonds.
List on the back of the application all household and medical expenses. If it is necessary to list this on another piece of paper, please attach this also.
Please mail this information to the following:
Maury Regional Hospital
ATTN: FINANCIAL COUNSELOR
1224 Trotwood Avenue
Columbia, TN 38401
If you have any questions regarding how to complete the application, please contact the Business Office at 931.380.4084. Thank you.
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