Transparency: Financial Policy and Billing Information
Doctors” Memorial Hospital is committed to meeting the needs of the community. As a not-for-profit system, DMH provides non-elective services to patients without regard to financial status or ability to pay. At the same time, DMH relies on income from patients to reinvest in clinical programs aimed at strengthening and promoting the health of the community. We ask that you cooperate in meeting your financial obligation to DMH. If you need assistance with your medical bill at DMH, or, if you would like to apply for financial assistance, please contact us at:
Patient Financial Services
333 N. Byron Butler Parkway
Perry, FL 32347
850-584-0862 or 850-584-0863
Monday through Friday
8:30 – 4 p.m.
For questions regarding your DMH Clinic bills, you may contact the clinic where you received care directly or, call our clinic patient account representative at 850-584-0660.
Clinic contact information is listed below:
Doctors’ Memorial Family Practice
555 N. Byron Butler Parkway
Perry, FL 32347
Doctors Memorial Family Medicine
117 SW Virginia Circle
Mayo, FL 32066
Steinhatchee Family Medicine
1209 1st Ave South
DMH Surgical Services
1218 N Peacock Ave
Perry, FL 32347
The billing process begins when you register for services at the hospital or, have an appointment with your physician or provider at one of our DMH clinics. You will be asked to provide any health insurance information or other insurance information such as auto or workman’s comp if applicable, at the time of service.
As a courtesy, we will bill your insurance company directly. Depending on the insurance you have, you may be asked to pay your portion such as a specific co-payment, co-insurance or deductible amount as your share of the cost.
Your insurance coverage is an agreement between you and your insurance company. Please be sure to refer to your insurance policy guidelines and benefit information with questions about your coverage.
Once your insurance has processed the claim, you will receive a statement for any patient balance due. If you have questions, please contact Patient Financial Services at 877-418-2061 or, 850-584-0863. If you are unable to pay the bill in full, a payment plan may be established. If you are unable to pay your bill, you may qualify for financial assistance. Please refer to the section titled Financial Assistance for more information.
Types of Insurance Accepted by DMH
Doctors’ Memorial Hospital accepts most insurance types (see below for a list of participating providers). If DMH is a participating provider, your insurance will receive a discount based on a contract with DMH. We bill the insurance provider on your behalf. Any amount indicated as patient responsibility after your insurance has paid, will be billed to you. If DMH is not a participating provider by contract with the insurance company, you will be responsible for any amount not paid by your plan. In addition, you may receive services at DMH by independent providers, such as radiologist, pathologist or emergency room physicians. Please note that hospitals may not be included in all health plan offerings. Please check with your insurance company for more information.
Independent physicians may bill you separately. You should contact your insurance plan to determine if these providers are in network or, participating with your plan. A list of provider groups that offer services independent of DMH may be found below (list of independent providers).
Doctors’ Memorial Hospital, Inc. participates with government sponsored plans such as Medicare, Medicaid, Tri-Care and Veterans Administration. Regardless of the type of coverage, it is your responsibility to provide an insurance card at time of registration so a claim can be submitted to your plan.
It is your responsibility to ensure we have accurate, current insurance information on file. If you provide insurance information after the time limit for filing has past, the bill may be your responsibility.
Private insurance Plans Accepted
Please see the list below of private insurance plans we are participating providers for at Doctors’ Memorial Hospital, Inc. If you do not see you plan listed below, please call us at 850-584-0863 to see if we accept your plan.
Blue Cross Blue Shield
Children’s Medical Services
Coventry Health (First Health)
Clear Heath Alliance
Humana Military – Tricare
Magellan Behavioral Health
Prestige Health Choice
Simply Health Plans
Sunshine Health Plan
Wellcare / Staywell
List of Independent Providers
Eye Associates of Tallahassee
KWB Pathology Associates
Southern Medical Group
Southeastern Urological Center
Tallahassee Orthopedic Clinic
TMH Physician Partners
Hospital Sponsored Financial Assistance Program
Financial Assistance Program Summary
Doctors’ Memorial Hospital is committed to meeting the healthcare needs of the community. As a not-for profit hospital, Doctors’ Memorial Hospital provides emergency and medically necessary services to all patients without regard to status or ability to pay.
If you anticipate any difficulty in paying your hospital or clinic bill, or, if you would like to apply for financial assistance, please contact our Patient Financial Services representative at, 850-584-0862, or 850-584-0863
Monday – Friday 8 am to 4:30 pm. You may obtain a copy of the financial assistance application HERE.
You may also obtain a paper copy of the financial assistance policy and application form at any registration location of the hospital, DMH Clinics or, the Business Office.
The DMH Financial Assistance Policy and Procedure can also be found HERE.
A patient or their representative may request financial assistance prior to receiving, while receiving or after receiving services at Doctors” Memorial Hospital. The eligibility determination shall be applied regardless of race, color, creed, sexual orientation or immigration status. Applications are processed for all who complete the application process. Financial assistance is administered on an individual basis taking into consideration your income, family size and other specific needs or circumstances.
The Application Process
All patients requesting financial assistance must complete a Financial Assistance Application. The applicant is required to provide documentation that supports their family’s current level of income, available assets and expenses. Examples of income include tax returns, W-2 forms; Social Security benefits disability statements, etc. If you cannot provide these documents, you may still be able to apply. Please schedule an appointment with our Patient Financial Services representative by calling 850-584-0862. Or 850-584-0863.
Financial Assistance Decision and Notification Process
Doctors’ Memorial uses Federal Poverty Guidelines issued by the U.S. Department of Health and Human Services to determine a patient’s eligibility for financial assistance. The amount of discount varies based on your income and family size. If your income, adjusted for family size is 200% of the poverty level or lower, financial assistance may be provided. If your income is above 200% of the Federal Poverty Levels, other discounts may apply. The applicant will be notified within 30 calendar days of receipt of a complete application.
Contacting the Financial Assistance Program at DMH
Patient Financial Services representatives are available to assist you in understanding the financial assistance program and to answer any questions you may have. Should you need assistance in any other language besides English, the program may be able to provide a translator for you. The financial counselor will also be able to assist or inform you of other programs such as Medicaid, Disability and Vocational Rehabilitation Services that may assist you with your hospital bill. Our financial counselors will also be able to direct you to healthcare navigators within our community that can assist you with finding insurance through the market-place exchange.
How Do I Obtain An Estimate For Services?
Cost of care estimates are provided upon request. To obtain an estimate, please call our Patient Financial Services Department at 850-584-0154, Monday through Friday 8:30 -4 p.m.
Estimates may be provided to you electronically or, in writing.
It is important that you contact your insurance plan concerning your cost-share responsibilities.
Can I Get an itemized Bill?
Itemized bills are provided upon request. To receive and itemized bill, please contact Patient Financial Services at 850-584-0863, Monday through Friday. 8:30-4
What Happens If I Don’t Pay My Bill?
Your hospital bill is due at the time of service. However, if you have insurance, we will seek payment from your plan prior to billing you for any patient balance. If you do not have insurance, you will start receiving statements soon after your discharge date. When you start receiving statements, payment is expected. If you are unable to pay the balance 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 not payment is received and no payment plan established, you will continue to receive statements from DMH before your account is referred to an external agency for collection. If your account is referred to an external agency for collection, you will receive notice from them about the placement and will be given opportunity to make arrangements for payment of the account. At any time in this process, you will still be able to apply for financial assistance. Please be aware that after placement with the collection agency, an account may be reported on your credit as a delinquent claim.
Patient Rights and Responsibilities
Quality of Service Information
Information regarding quality measures that are reported to the public by organizations such as the Centers for Medicare & Medicaid Services (CMS), and the Florida Agency for Healthcare Administration.
The following websites include quality measures:
Questions, Concerns and Complaints
We value your feedback. If you have a question, concern or complaint about the quality of care you or a family member receives at Doctors’ Memorial, we encourage you to speak directly to the department that was involved in the situation you are concerned about. However, if you prefer to speak to our Patient Advocacy Office, they can be reached at 850-584-0609.
Florida Agency for Health Care Administration
The Agency for Health Care Administration has statutory authority for regulating hospitals and ambulatory surgical centers in Florida. If you have a complaint against a hospital or ambulatory surgical center, call the Consumer Assistance Unit at 888-419-3456, (press 1) or write to:
Agency for Health Care Administration
Consumer Assistance Unit
2727 Mahan Drive/Bldg. 1
Tallahassee, FL 32308
If you have a complaint against a health care professional and want to receive a complaint form, call the Consumer Services Unit at 888-419-3456 (press 1) or write to:
Agency for Health Care Administration
Consumer Services Unit
P.O. Box 14000
Tallahassee, FL 32317-4000