Combined clinic and hospital statements & bill pay online. If you log in after May 14, watch for our new look.
Pay your balance in full and receive
a 10% discount.
Questions? Call Billing Customer Service
You will receive separate bills from both the hospital and physicians until our new combined statement begins on May 14, 2014. Prior to May 14, your hospital bill does not include fees from the Radiologist, outside physicians, or emergency other specialists. You will receive a separate bill from these physicians. For your hospital bill at the patient's request, a detailed bill may be provided.
Once the balance is self pay, the hospital will send monthly statements to the patient or responsible party to keep them informed of the status of all open accounts. If you have questions regarding your hospital or clinic bill please contact Patient Business Services at 920-320-2591 or email firstname.lastname@example.org.
Patients are responsible for the charges for services received. However, to assist patients in meeting their financial obligations, we will bill their health insurance carrier(s), as long as a valid ID card or information regarding insurance coverage is presented at the time of registration.
We accept assignments of benefits and maintains an active follow-up program with all insurance carriers. Insurance is billed as a courtesy to the patient and the patient remains responsible for contacting their insurance carrier to ensure prompt payment of their accounts. Patients should contact their insurance if payment has not been made within 45 days.
Unpaid balances, including all applicable co-payments, co-insurance, deductibles and any non-covered services are the responsibility of the patient and must be paid within 30 days of receipt of the statement.
Payments may be made via:
- Cash, check, or money order
- Visa, MasterCard, Discover
- Automatic Check Withdrawal
- Extended Financing
Patients that are uninsured or fail to provide us with adequate billing information including proper managed care authorization referrals, are responsible for the total payment of their bill. If you have any questions or need to make payment arrangements to resolve your account, please call Patient Business Services at 920-320-2591.
Any payment arrangements, other than payment in full must be approved in order to keep your account from being considered past due.
We are committed to providing quality health care to every person who is in need regardless of ability to pay. Patients without insurance will receive an uninsured discount, which is reflected on the patient statement. Uninsured patients may also qualify for an additional discount based on household income. This discount is provided through the Community Care application process.
Community Care Program - view details
To receive an estimate of charges for services you may need, please call 920-320-2595.
Other Bills you may receive
In addition to your Holy Family Memorial bills, you may receive bills from other physicians who may have provided services to you. For instance, you may receive bills from radiologists or other specialists. Please contact their office directly if you have any questions concerning their bills.