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FAQ

Health Center Billing FAQ

When do Health Center bills get mailed?

Health Center statements are typically mailed between the 10th and 15th of the month. While St. Camillus pre-bills for room and board charges, we must wait for outside service providers (i.e. pharmacy, medical supplies, etc.) to submit their charges in order to complete the billing process.

When is my payment due?

Payment is due upon receipt of the statement.

Who should I call if I have other questions regarding a Health Center statement?

You should call Pat Lewis at (414) 259-8366.

What is Co-Insurance A?

Co-Insurance A relates to Medicare Part A charges. Medicare pays 100% of the first 20 days for an approved stay in a skilled nursing facility. Starting on the 21st day, Medicare covers all but $114 per day. The $114 per day the patient is responsible for is called Co-Insurance A. This amount can be billed to a secondary insurance if the patient has one. St. Camillus will bill this directly to the insurance company, but it will continue to show on the monthly statement because the patient is still ultimately responsible.

What is Co-Insurance B?

Co-Insurance B relates to Medicare Part B charges. Medicare B is billed for all out-patient services provided by St. Camillus Health Center (i.e. Therapy). Medicare B pays 80% of the approved amount starting on the first day of service, the remaining is the clients responsibility and can be billed to a secondary insurance. St. Camillus will bill this directly to the insurance company but it will still show on the monthly statement because the client is still ultimately responsible. It is important to note that the Co-insurance is an estimated amount. It may increase or decrease upon Medicare’s determination.

Do I need to pay the Co-Insurance now or can I wait for my insurance company to pay it?

If you do not have a secondary insurance carrier, yes you should pay it immediately. However, if you have a secondary insurance carrier, it is an option of yours to either pay it now or wait for a response from the insurance company. If you pay the co-insurance amount and your secondary insurance carrier does in fact pay St. Camillus, we will issue you a reimbursement of this dollar amount.

What is patient liability?

Patient liability applies to individuals on Medicaid (Title 19). Patient liability is the amount assigned by the State of Wisconsin that a resident must pay while residing in a skilled nursing facility. A basic calculation of patient liability is a patient’s monthly income (i.e.  pension, Social Security) minus $45.

Why am I being charged for a telephone installation?

The fee is for activating the telephone jack in the patient’s room and for setting-up an account for any long distance calls placed by the patient. This service is performed by our Telecommunications Technician. Typically this fee is only charged to new residents. Should a resident transfer from one room to another, this fee is waived.

If I have questions regarding the medication the patient is being charged for, who should I contact?

You could either call Roeschen’s Omnicare at (414) 486-3100 or the nurse manager on the unit.

Medicaid (Title 19) FAQ

What is Title 19?

Title 19 of the Social Security Act is a Federal/State entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources. This program, known as Medicaid, became law in 1965 as a cooperative venture jointly funded by the Federal and State governments to assist States in furnishing medical assistance to eligible needy persons.

How do I qualify for Medicaid (Title 19)?

There are low income and resource requirements for both single and married couples.

Is there a minimum or maximum age to qualify for Medicaid (Title 19)?

No.

How do I attain Medicaid (Title 19)?

You must apply to the Department of Health and Family Services of the State of Wisconsin.  If you are a prospective or current resident you may obtain a blank application online. Assistance with completing the application is available for a fee by contacting St. Camillus Care Management at 414-259-4611.

Do I need an attorney to apply for Medicaid (Title 19)?

An attorney is not necessary to apply for Medicaid (Title 19).

How much money should I have before I call to apply for Medicaid (Title 19)?

For a single person you should contact Pat Lewis at (414) 259-8366 when your liquid assets fall below $30,000. For a married couple, you should contact Pat Lewis when your assets fall below $125,000. However, every situation is unique, so please call if you have any questions regarding this. Pat is available to assist prospective and current St. Camillus residents only.

Who should I call if I have any questions or if I believe I qualify for Medicaid (Title 19)?

If you are a prospective or current St. Camillus resident, you should contact Pat Lewis at (414) 259-8366.

What information will I need in order to apply for Medicaid (Title 19)?

The following information is required to complete the application process. If the applicant is married, this information is needed for both husband and wife.

  • Birth Certificate or Baptismal Certificate
  • Marriage certificate (if applicable)
  • If an alien, alien card or citizenship
  • Social Security and Medicare Card
  • Health Insurance card and verification of health insurance premium
  • Liquid asset verification (savings, checking, cash on hand, stocks, bonds, certificate of deposits, annuities, IRAs, etc.)
  • Burial Trust
  • Power of Attorney or guardianship papers
  • Car title
  • Most recent tax bill on home
  • Life insurance verification (face and cash value)
  • Copies of all bank statements when resident entered St. Camillus Health Center and of the last 6 months

What programs or services at St. Camillus accept Medicaid (Title 19)?
We are licensed to accept Medicaid (Title 19) at St. Camillus Health Center (skilled nursing facility) and at Camillus CARES (home health agency).

What costs are covered by Medicaid (Title 19)?

For St. Camillus Health Center patients (skilled nursing facility) it covers:

  • Room and board in a semi-private room
  • Medical supplies
  • Medications prescribed by a physician
  • Therapy services prescribed by a physician
  • Personal care items (i.e. shampoo, toothpaste, etc.)

What costs are NOT covered by Medicaid (Title 19)?

For St. Camillus Health Center patients (skilled nursing facility)  it does not cover:

  • Beauty and barber services
  • Satellite or cable television
  • Telephone charges
  • Private rooms
  • Smoking materials
  • Over-the-counter medications
  • Fees for recreational activities
  • Clothing
  • Newspapers/subscriptions
  • All other items not associated with the patient’s care

If I have Medicare (Title 18) do I have or do I qualify for Medicaid (Title 19)?

Not necessarily.  The qualifications for Medicaid (Title 19) are very different than those for Medicare (Title 18).

What is the difference between Medicare (Title 18) and Medicaid (Title 19)?

Medicare is the health insurance program administered by the Federal Centers for Medicare and Medicaid Services (CMS) for people 65 years of
age or older, people of any age with permanent kidney failure, and some disabled individuals under age 65.

Medicaid (Title 19) of the Social Security Act is a Federal/State entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources. This program became law in 1965 as a cooperative venture jointly funded by the Federal and State governments to assist States in furnishing medical assistance to eligible needy persons.

Have a question not answered here? For more information on St. Camillus Skilled Nursing, contact us or request a tour.