Billing Insurance Information

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Cook Medical Center

Patient Financial Services

706 North Parrish Avenue, Adel, GA

(229) 896-8000

Allow Us to Assist You

Representatives with Cook Medical Center’s (CMC) Financial Services are available to help answer questions patients and family members may have about insurance coverage, deductibles, co-insurance and payment arrangements. They will be glad to explain your insurance benefits and requirements related to your CMC bill; explain Medicare requirements; estimate your bill; assist with special payment arrangements; and refer you to a financial assistance program.  If they cannot answer your question, they will direct you to someone who can.

 

Deductibles, non-covered services and co-insurance amounts may be paid before or at the time of the hospital stay.

 

If You Have Insurance

Cook Medical Center(CMC) works with many insurance carriers. However, some insurance plans require you to go to a specific provider or network. Others require you to obtain pre-authorization. To avoid surprises, contact your insurance company to see what they require.

CMC will bill the primary and secondary insurance carriers and provide additional information as needed to process your hospital claim.  Once the insurance carrier pays its portion of the bill, or if the carrier denies payment of the bill, the balance of the account becomes your responsibility.  Services provided by a physician will be billed separately from hospital charges by the physician’s billing service.

After Your Insurance Pays
You will receive a billing statement after payment by your insurance carrier. This statement will include total charges for services and any payments made by the insurance company. Other correspondence may be sent or calls made to help keep you informed of the account balance and any payment you are expected to make. To receive an itemized statement, please call (229) 353-6124. To receive your itemized statement please include patient name, account number and date of birth.

Payment Options
Check, cash, credit or debit card accepted.

Payments can be made at the Patient Financial Services office, Monday through Friday, 8:00 a.m. to 5:00 p.m., or by mail. CMC accepts Mastercard, VISA, American Express and Discover credit cards. To utilize a credit card, present your card at the cashier's window or return your credit card information by mail on the billing statement.  You can also use a credit or debit card online by clicking here.

If You Have No Insurance or Expect a Large Bill
A CMC Patient Financial Services representative can investigate options such as government programs or financial assistance with you. This is best done ahead of time or during your hospital stay.

If you feel your bill is too large to handle, CMC can help you with the financial assistance process. For qualified patients, CMC offers a financial assistance program for full or partial reduction of the hospital bill. The criteria for financial assistance is based on income, available assets and family size. An application and income verification are required.  Accounts are considered on an individual basis.

If you are interested in applying for financial assistance on your bill(s), you will be required to complete a form and provide proof of your family’s income.  This form can be obtained at the CMC Patient Financial Services department located across the street from the hospital at 706 North Parrish Avenue, Adel, GA 31620.  Please include patient name, account number (if available) and date of birth.  Proof of income may consist of:

  • Previous year’s tax return (required if claiming dependents other than spouse)
  • Previous 3 month’s pay stubs prior to the date of application (i.e. if you are paid weekly this would be 12 pay stubs; if you are paid bi-weekly this would be 6 pay stubs)
  • Benefit award letters (Retirement, Pension, Social Security, Workers Compensation, Unemployment, Short Term Disability, Long Term Disability)
  • Current bank statement showing direct deposit-Social Security or Retirement only
  • Written statement from person giving support that includes type of support, length of support as well as the relationship to the patient
  • Written statement from employer, on letterhead when available

All proof of income must be dated within 30 days from the date of application.  If you are unable to bring the application to our office, Tift Regional Health System, Attn:  PAS Financial Counselors, PO Box 747, Tifton, GA  31793.  We will also accept faxed applications, if legible.  Our fax number is 229-353-7722.

Indigent Care Policy
Cook Medical Center participates in the Indigent Care Trust fund, sponsored by the State of Georgia Department of Community Health Division of Medical Assistance.  It is the policy of Cook Medical Center to extend free care to persons who qualify under the guidelines of this program (below).

2017 INCOME LEVEL  

 Family Size

 125% Indigent

 200% Charity

 1

 $15,075.00 per year

$24,120 per year 

 2

$20,300.00 per year 

$32,480 per year 

 3

 $25,525.00 per year

$40,840 per year 

 4

 $30,750.00 per year

 $49,200 per year

 5

$35,975.00 per year

$57,560 per year

 6

$41,200.00 per year

$65,920 per year

 7

$46,425.00 per year

$74,280 per year

 8

$51,650.00 per year

$82,640 per year

For family units over 8

$5,225 per year for each
additional member

$8,360 per year for each
additional member

If you need assistance with completing the application or have questions or concerns you may reach a Financial Counselor at 229-353-6124, option 2.