The Financial Services department assists patients through multiple areas of the hospital including: Financial Counselors, Cashier, Customer Service Call Center, Central Registration, Pre-Registration, Business Office, Scheduling and Operators.
If you have general questions or concerns about your hospital bill, call our Customer Service number at (256) 737-2986, Monday-Friday, 8:00 am – 4:30 pm.
- (256) 737-2986
- Pay My Bill
Insurance / Medicare
Prior to hospital admission, you will be asked to provide your insurance identification card. Our staff will verify your coverage, review your benefits and estimate the amount due from you. You will be responsible for deductibles, copays and/or charges above that coverage and will be asked to pay those amounts prior to or during your stay.
While we will strive to optimize your insurance coverage, patients are ultimately responsible for charges incurred when using hospital services. A financial counselor may visit your room during your stay to explain your financial obligation and assist you in establishing payment arrangements. If you have questions, assistance may be obtained by calling one of the following:
For last names beginning with A-L, call (256) 737-2678
For last names beginning with M-Z, call (256) 737-2677
Price Transparency – Patient Price List
Your hospital bill does not include fees for the professional services of your physicians, anesthesiologists, surgeons or consulting physicians. You may also receive bills from specialists, which include radiologists or pathologists who bill separately for their services.
Charity Policy and Application
Charity financial assistance is available to eligible patients receiving medically necessary services. You are required, however, to complete the Financial Assistance Application and submit supporting documentation to verify your need for financial assistance.
Plain Language Statement
Cullman Regional will provide Financial Assistance for eligible patients who require emergency or medical urgent services. The eligibility is based on 200% of the Federal Income Poverty guidelines which are generally updated by the government in February of each year (click here for the guidelines). Proof of income and other documentation is necessary to determine eligibility; however, administrative waiver may be granted under unusual circumstances. A free copy of the application may be obtained in one of 4 ways:
- Online (click here to apply online)
- Printable copy (click here to download a printable copy)
- By mail: Call our Customer Service Representative at (256) 737-2986 or contact our Financial Counselor at (256) 737-2986 or (256) 737-2677.
- In person at Cullman Regional on the Ground Floor of the main Hospital. The hospital is located at 1912 Alabama Highway 157, Cullman, AL 35058.
- A Spanish Translation of the Financial Assistance Policy, Financial Assistance Application Form, and Plain Language Summary is available by clicking the Spanish tab above.
Please contact a Financial Counselor, individuals with the hospital department who provide information about the Financial Assistance Policy, if you need information about the Financial Assistance Policy, assistance in understanding or completing an application. Once a complete application is submitted, it will be reviewed by hospital management. You will be notified by mail if approved or denied.
Note that Financial-assistance policy individuals or payers are never charged more than the amounts generally billed to other individual or payers. Also on this site you can find current providers that have privileges at Cullman Regional, and could potentially provide you medical care; however, only employed providers of Cullman Regional are eligible for discounted or free care under this policy.
- For a complete list of providers (physicians and practitioners) who are covered by the hospital’s Financial Assistance Policy, please click here.
- For a complete list of medical staff members who have privileges at Cullman Regional but are not covered by Cullman Regional’s Financial Assistance Policy, click here.
Identifying Patients Needing Financial Assistance
- At any time during an initial financial screening and continuing collections process, patients who claim to lack the ability to pay will be offered a Financial Assessment Application.
- A hospital representative will review and explain the process. We assign patients Financial Counselors by the last name. If your last name begins with A-L, call (256) 737-2678, if your last name begins with M-Z, call (256) 737-2677, Monday-Friday, 8:00 am – 4:30 pm.
Cullman Regional uses the Federal Poverty guidelines to determine eligibility for charity consideration. The guidelines are based on annual income and family size, and are adjusted by the government annually. You may qualify for a full or partial discount on charges. Patient’s annual household income will be compared to eligibility guidelines based upon 200% of Federal Poverty Levels (FPL). Click here for the Guidelines, or contact the Patient Financial Services Department at (256) 737-2986.
Applying for Financial Assistance
- The Financial Assessment Application must be complete in its entirety.
- Click here to complete an application online.
- Within 10 days of receipt, the patient must return the application and supporting documents.
- Additional time may be granted in extenuating circumstances.
- Supporting documentation includes, but is not limited to:
- Click here for a printable copy the application.
- Most recent year’s income tax return
- Copy of Social Security cards or formal identification for all household members included in income guidelines
- Most recent month’s checking and savings account statements
- Documentation of all monthly payment obligations reported on application
- Proof of income: paycheck stubs or a notarized memo from employer. Employer’s name, address and phone number must be included on proof of income.
- Notarized verification of financial support received from friends, family, churches, charitable organizations, etc.
- Written verification of a pending disability case
Exclusions to Supporting Documentation Requirements
- Administrative Determination
- Cullman Regional Administration may, on a case-by-case basis and not with prior determination, exempt a patient from requested documentation in the event of extenuating circumstances.
- Details of extenuating circumstances will be documented in the financial counselor’s summary and recommendations.
- Medicaid Recipients
- Patients with Medicaid who exhaust their Medicaid coverage for a specific aide category, indicated on the Medicaid Remittance Advice, will receive a 100% adjustment to the specified account balance. Cullman Regional’s Business Office will confirm that the recipient ID was correct on the Medicaid claim.
- For patients under 21 years of age, the Cullman Regional Business Office will confirm that there is no Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Referral that should be used on the claim.
- Good Samaritan Health Clinic Patients
- Those with a qualifying Good Samaritan Health Clinic Patient Identification Card in effect for the date of hospital service will not be required to complete the Financial Assessment Application.
- The Good Samaritan Health Clinic will maintain supporting documentation.
Charity Review and Assessment
- Financial counselors will review your application with supporting documents, obtain a consumer credit report, summarize the information and recommend approval or denial. Your annual household income will be compared to eligibility guidelines based upon 200% of Federal Poverty Levels.
- Cullman Regional’s Patient Financial Services Manager, Patient Financial Services Director and/or Chief Financial Officer will review and assess recommendations.
- A financial counselor will notify you of your eligibility and explain any payment required.
DECLARACIÓN EN LENGUAJE SIMPLE
Cullman Regional brindará asistencia financiera a los pacientes que califiquen que necesiten servicios de emergencia o de urgencia médica. La elegibilidad se basa en el 200% de los lineamientos que definen el Índice Federal de Pobreza, que generalmente el gobierno actualiza en febrero de cada año (haga clic aquí para conocer los lineamientos). Para determinar la elegibilidad es necesaria la prueba de ingresos y otra documentación; sin embargo, en circunstancias inusuales, puede concederse la renuncia administrativa. Se puede obtener una copia gratuita de la solicitud de 4 maneras:
- En línea (haga clic aquí para hacer la solicitud en línea)
- Copia imprimible (haga clic aquí para descargar una copia imprimible)
- Por correo: Llamando a nuestro representante de Servicio al Cliente al (256) 737-2986 o contactando a nuestro asesor financiero al (256) 737-2986 o al (256) 737-2677.
- En persona en Cullman Regional, en la planta baja del hospital principal. El hospital está ubicado en 1912 Alabama Highway 157, Cullman, Alabama 35058.
Por favor, contacte al asesor financiero si necesita ayuda para entender o completar una solicitud. Una vez que se envía una solicitud completa, la gerencia del hospital la revisará. Se le notificará por correo si la misma fue aprobada o rechazada.
Considere que a los solicitantes de ayuda financiera nunca se les cobra más de los montos que generalmente se facturan a otras personas o pagadores. Asimismo, en este sitio puede encontrar proveedores actuales que tienen privilegios en Cullman Regional y que potencialmente podrían brindarle atención médica; sin embargo, sólo los proveedores empleados de Cullman Regional califican para recibir descuentos o atención gratuita en virtud de esta póliza.
No Surprise Billing Act
Plain Language Statement
The Department of Health and Human Services (HHS) has developed rules to provide protection for consumers of medical services from “Surprise Billing.” In general terms what this means is that providers that are non-participating, or commonly known as “Out-of-Network”, with a patient’s insurance plan can’t bill the patient in excess of the amounts that the patient would be responsible for had their plan been in network. This provision does not apply to Medicare, Medicaid and certain other Federal programs. It also doesn’t apply to all situations.
Cullman Regional participates, meaning we are “In Network”, with most local and state plans and have contracted rates with those plans. In the event that you require, or request, services from a plan that we aren’t contacted with we will work with that plan to determine what you would have owed had we been In Network and will adjust your bill accordingly. If you are uninsured, or choose not to file your insurance, we will provide you with an estimate of your out-of-pocket cost.
For additional information, click the tab below labeled “Your Rights and Protections Against Surprise Medical Bills” or go to https://www.cms.gov/nosurprises.
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or 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 other 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” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted 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:
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 and coinsurance). 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 get 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.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
- You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay 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 (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.
If you believe you’ve been wrongly billed, you may contact the third party arbitrator listed on the website below.
Visit https://cms.gov/nosurprises for more information about your rights under federal law.