Billing Insurance Information

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) 686-8000 and ask to speak with a patient financial servicles employee. 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:

Tax return
2 consectutive check stubs
Written statement from employer
Bank statment showing direct deposit - Social Security/Retirement only
Statement from Social Security
Written statement from person giving support

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, you may mail it to our Patient Financial Services office, but we would like to encourage you to bring the application into the office if at all possible. Mailing address: Tift Regional Medical Center, PFS Deptartment, 706 North Parrish Avenue, Adel, 31620.

A representative from CMC can explain the process, assist with the application and file the application and required documentation.

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).

INCOME LEVEL
Family Size	125% Indigent	200% Charity
1	$13,962.50 per year	$22,340 per year
2	$18,912.50 per year	$30,260 per year
3	$23.862.50 per year	$38,180 per year
4	$28,812.50 per year	$46,100 per year
5	$33,762.50 per year	$54,020 per year
6	$38,712.50 per year	$61,940 per year
7	$43,662.50 per year	$69,860 per year
8	$48,612.50 per year	$77,780 per year
For family units over 8	$4,950 per year for each additional member	$7,920 per year for each additional member