Billing and Financial Assistance Information

Tallahassee Memorial Financial Policy

Tallahassee Memorial HealthCare (TMH) is committed to meeting the health care needs of the community. As a not-for-profit system, TMH provides non-elective services to patients without regard to financial status or ability to pay. At the same time, TMH relies on income from patients to reinvest in clinical programs aimed at promoting the health of the community. We ask that you cooperate in meeting your financial obligation to TMH. However, if you anticipate any difficulty in paying your hospital bill, or if you would like to apply for financial assistance as outlined below, please contact

Patient Financial Services
850-431-6200 or
Toll-free: 800-492-4892 ext 16200
Monday through Friday
8:30 - 4 p.m.

Before You Receive Services

Your physician will contact TMH to schedule services. Once services are scheduled, a Patient Account Representative will review your insurance information and confirm your benefits. They will also ensure any prior authorization requirements have been met. They will prepare an estimate of charges customized to your insurance plan and contact you to discuss your estimated out-of-pocket expenses. You have a right to request an estimate prior to services and to receive it within seven (7) business days of your request. In addition, you have a right to receive a revised estimate should your scheduled services be changed by your physician. Even if you do not have insurance, you may still request an estimate. Please contact a representative at 850-431-5497 if you have any questions regarding estimates.

Cost Estimates

You may obtain an estimate of charges for services to be performed at TMH by clicking on the link below. This estimate will be based on facility charges only, and will not include any charges for your private physician, anesthesiologist, pathologist, radiologist, emergency room physician, hospitalist, or any other private practitioner. This is an estimate only. The actual charges for your service will depend on many factors, including additional services rendered, complications, and unforeseen circumstances. If you have insurance, your estimate will be based on your specific insurance benefits. Please have your insurance information available to complete the estimate. If you do not have insurance, your estimate will be based on the uninsured charge for the service being performed.

Get a Cost Estimate

In addition to obtaining an estimate, you can download a file of standard charges for services provided by TMH. Please use Google Chrome to avoid any difficulties in downloading the file.

If you have questions regarding your estimate, please contact us at patientestimate@tmh.org, or at (850) 431-5497.

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit CMS.GOV/NOSURPRISES or call 1-800-985-3059.

Service Bundles

For information on service bundles, please visit FloridaHealthPriceFinder.com. Service bundles are non-personalized estimates of costs that may be incurred for hospital services, and include all components of care, such as physician, ancillary and hospital payments. Actual costs will be based on services actually provided, and may be more or less than the estimates found on FloridaHealthPriceFinder.

In addition, you should contact the healthcare providers anticipated to provide services while you are in the hospital to obtain an estimate of their costs, inquire about their billing practices, and determine if they participate in your health plan.

Standard Rates

The information in the files below is current as of the date posted, and is updated annually in January. For the most accurate estimate of your financial responsibility for services provided by TMH, please contact us directly at 850-431-5497. We can provide a customized estimate based on your specific insurance plan and services to be provided.

Schedule of Standard Rates for Services

Average Rate by Procedure

What Happens After I Receive Services At TMH?

Once you receive services, charges will be entered on your account based on the services you received. These charges will be based on amounts generally billed to private insurance carriers, as well as government payers such as Medicare. Diagnosis codes will then be entered representing the care provided. If you provided insurance information at the time of service, a claim will be submitted to your insurance company. Once your insurance company has processed the claim, you will receive a statement for any patient balance due. If you have questions when you receive your statement, please contact Patient Financial Services. If you are unable to pay in full, a payment plan may be established. If you are unable to make any payment, you may qualify for financial assistance, as outlined below.

What Types of Insurance Does TMH Accept?

Tallahassee Memorial Hospital generally accepts any type of insurance provided (see below for a list of accepted providers). If TMH is a participating provider, your insurance company will receive a discount based on its contract with TMH. Any amount indicated as patient responsibility will be billed to you after insurance payment. If TMH is not contracted with your insurance company, you will be responsible for any amount not paid by your plan. In addition, you may receive services from independent providers, such as radiologists, pathologists, etc. In these cases, you will receive a separate bill from those providers. You should contact your insurance company to determine if the independent providers are in your network. Remember that your plan is a contract between you and your insurance company. We will make every effort to bill your insurance and work with your insurance company, however, you are ultimately responsible for your bill with TMH.

Physicians who are affiliated with TMH and may bill separately are listed in our physician directory.

Please note that hospitals may not be included in all health plan product offerings. Please check with your insurance company for more information.

In addition to commercial insurance plans, TMH participates with Medicare, Medicaid, Tricare, and other government-sponsored programs. Regardless of the type of coverage, please be sure to provide an insurance card at registration so a claim may be submitted to your plan. If we are not notified of your insurance at the time of service, penalties may be applied for late notification. It is your responsibility to ensure we have accurate, current insurance information on file. If you need to provide insurance information after service, please contact Patient Financial Services.

Private Insurance Plans Accepted

Please see the list below of private insurance plans accepted at Tallahassee Memorial HealthCare. If you do not see your insurance plan listed, please call us at 850-431-6200 to see if we accept your plan.

Aetna
Beech Street
Blue Cross/Blue Shield of Florida
Capital Health Plan
Cenpatico Behavioral Health
Choice Care (Humana)
Cigna Healthcare of Florida
Cigna Behavioral Health
Community Health Solutions of America (CHS)
Florida Medicaid
Georgia Medicaid
Humana Military (Tricare)
Humana Veterans Healthcare
Lighthouse Health Plan
Magellan Behavioral Health
Naphcare
New Directions Behavioral Health
Novanet
Prestige Health Choice
Private Healthcare Systems
Simply Health Plans
United Behavioral Health
United HealthCare of Florida
Value Options
WellCare Health Plans

What If I Don’t Have Insurance?

Tallahassee Memorial Hospital provides medically-necessary services to patients without regard to their ability to pay. If you do not have insurance, you may receive a discount, which will be reflected on your first statement. You may also be eligible for financial assistance. Finally, you may qualify for a government-sponsored program like Medicaid. We have representatives available to assist you with managing your hospital bill. Please contact Patient Financial Services with any questions.

Hospital-Sponsored Financial Assistance Program

The Hospital Sponsored Financial Assistance Program (FAP) is available for uninsured and underinsured patients. The FAP is a free care and sliding scale discount program based on the patient’s family income and household size. Uninsured and underinsured patients with family incomes at or below 150% of the Federal Poverty Guidelines (FPG), or whose total liability exceeds 25% of the annual family income, are eligible for 100% charity. Uninsured and underinsured patients with family incomes between 151-400% of the FPG are eligible for discounted care that will be determined by household income and family size. Uninsured and underinsured patients with family incomes exceeding 400% of the FPG may be eligible for discounted care.

Financial Assistance Program Requirements

Patient does not have to be a U.S. citizen
Patient does not have to be a Florida resident
Patient is not eligible for Medicaid
Medicare patients are eligible only if they qualify for 100% charity based on income/household size
FAP applies to all patients regardless of age, gender, race, ethnicity, creed or national origin
There is no time limit for applying for FAP, including accounts in collections
FAP covers all medically-necessary, non-elective services
The patient’s liquid and non-liquid assets (excluding personal residence, retirement funds, and automobile) are considered in the final determination of financial assistance as possible sources of payment.

Financial Assistance Program Application Process

The Application for Assistance with Hospital Expenses will be used as the application form for the process.
One witnessed signature is required on the application (the patient, guarantor, or legal representative).
A FAP application can be used to cover services rendered 12 months after the date of the FAP approval.
All FAP applications and records will be scanned and retained for a minimum of 3 years.

Forms and Policies

Non-Covered Services

Cosmetic surgery
Non-medically necessary services, without extenuating circumstances

For Additional Information

Please contact Customer Service to request a copy of the financial assistance policy or with any questions regarding TMH’s Financial Assistance Program. Normal business hours are 8:30 – 4 pm, Monday-Friday.

Who to Contact

Patient Financial Services
850-431-6200 or
800-492-4892, ext 16200

What Happens If I Don’t Pay My Bill?

Your hospital bill is due at time of service. However, if you have insurance, we will seek payment from your plan prior to billing you for any patient balance. Whether you are insured or not, once you begin receiving statements, payment is expected. If you are unable to pay in full, a payment plan may be available. If you are unable to make any payment, you may qualify for financial assistance, as outlined above. If no payments are received, or no payment plan established, you will receive statements from TMH before your account is referred to an external agency, which will send additional letters in an attempt to collect. If no arrangements for payment have been made after these attempts, your account will be placed with an external agency for active collections. You will receive a notice from the agency immediately following placement. You will be given an opportunity to make arrangements for payment of the account. At any time in this process, you will be able to apply for financial assistance. After thirty (30) days from placement with the collection agency, the account may be reported on your credit file as a delinquent item.