Patient and Family Resources

Admissions

We want your experience at Alleghany Health to be as simple as possible. To help you with the admissions process, we encourage you or a family member to be familiar with your insurance coverage and any special requirements and/or restrictions specified by your insurance carrier. If you do not have insurance, special payment arrangements can be made.

Advance Directives

If you are 18 or older and mentally competent, you have the right to make decisions about your medical treatment. An advance directive is a set of directions you give about the health care that you want if you ever lose the ability to make decisions for yourself. North Carolina has two ways for you to make a formal advance directive. One way is called a living will. The other way is called health care power of attorney. Making a living will or designating a health care power of attorney is your choice. If you become unable to make your own decisions, and you have no living will or health care agent (a person named to make medical decisions for you), your doctor or health care provider will consult with someone close to you about your care.

For additional information regarding a living will or health care power of attorney, please visit the Registration Desk in the hospital lobby.

Case Management

At Alleghany Health, our case management services are designed to assist patients and family members with continuing care arrangements that may be necessary following discharge from the hospital. Our goal is to work with patients and family members, the healthcare team, and community-based agencies to develop a high quality, cost-effective plan that enables them to move smoothly through the healthcare system. Our case manager provides assistance with:

Establishing home health services
Facilitating the transition from acute care to the Alleghany Health swing bed program
Facilitating placement in alternative levels of care
Coordinating and scheduling needed therapies
Completing discharge planning
Ordering or procuring necessary durable medical equipment for home use
Utilizing our respite program.

Medicaid Patients

Important Changes Regarding N.C. Managed Medicaid – What You Need To Know

Open enrollment has closed for NC Managed Medicaid. If you did not enroll, NC Medicaid auto-enrolled you into a health plan so there is no lapse in your coverage.

You can expect to receive a confirmation notice and a health plan welcome packet from NC Medicaid. New plans will take effect on July 1, 2021. Read more information.

As a reminder: Alleghany Health and our Atrium Health Wake Forest Baptist and Hugh Chatham Memorial Hospital affiliates are in-network for the following plans in our region:

AmeriHealth Caritas
Blue Cross Blue Shield Healthy Blue
United Healthcare
WellCare

“In-network” means that Alleghany Health and its affiliates and providers accept each of the plans. Click here to view our providers.

You will continue to have access to your care providers until the new plans are implemented on July 1, 2021. After July 1, you can change your health plan or primary care provider for any reason through September 30, 2021. To make a change, contact the NC Medicaid Enrollment Broker. If you want to stay in the plan you are enrolled in, you do not need to do anything.

Important: If you have a medical emergency, you should go to the closest hospital emergency room. Alleghany Health and our Atrium Health Wake Forest Baptist and Hugh Chatham Memorial Hospital affiliates provide services to all patients seeking treatment for an emergency medical condition. It doesn’t matter what health insurance plan you have or if you can pay for emergency services.

Billing & Insurance

Patient Financial Services strives to provide quality assistance for patients and their families. Whenever you receive a bill from us, it covers the services you received at one of our healthcare facilities. As a courtesy to our patients, we will bill your insurance company, Medicare, or Medicaid on your behalf. We will do our best to obtain payment. You may also receive separate bills from your personal physician, surgeon, pathologist, radiologist, or other healthcare professional. Questions about any of these bills should be directed to the number printed on the statement you receive.

For your convenience, we accept payments via cash, check, credit card, and debit card. Payments can be made at the Financial Assistance office or front desk in the Main Entrance lobby from 8 a.m. until 4:30 p.m., Monday through Friday. After hours, payments may be made at the Emergency Department Registration Desk.

If you have insurance: We accept most major health insurance plans and managed care programs. Several factors can affect the amount a patient owes the hospital. Some insurance plans may have special requirements for specific tests or procedures. Additionally, some physicians may not participate in your healthcare plan, and their services may not be covered. If you fail to meet your health insurance plan requirements, you may be financially responsible for all or part of the services you receive at the hospital. We encourage you to review your benefits plan to understand your financial responsibility.

If you do not have insurance: No one will be denied necessary medical care due to lack of insurance or inability to pay. You may, however, be asked to pay a deposit when you are admitted or when you register for an outpatient procedure.

If you have questions or concerns about your account, please call our Financial Counselor at 336-372-3299.

NOTICE TO PATIENTS: This practice serves all patients regardless of inability to pay. Discounts for essential services are offered based on family size and income. For more information, ask at the front desk or visit our website. Thank you.
AVISO PARA PACIENTES: Esta práctica sirve a todos los pacientes, independientemente de la incapacidad de pago. Descuentos para los servicios esenciales son ofrecidos dependiendo de tamaño de la familia y de los ingresos. Usted puede solicitar un descuento en la recepción o visita nuestro sitio web. Gracias.

BILLING INFORMATION PROVIDED TO PATIENTS AFTER RENDERING SERVICES
A summary of charges is provided to patients after discharge. Please allow at least two weeks for this information to be forwarded. To view the Alleghany Health List of Charges, click here.

SHOPPABLE SERVICES
Alleghany Health has provided the file below to assist the consumer in identifying in advance the standard charges associated with 300 services at their facility. The information listed for each service reflects the following:

Standard Charge
Actual pricing can vary depending on ancillary services provided, number of days spent as an inpatient, drugs given, time spent in the OR, etc.
Ancillary codes are either listed as CPT codes or Revenue codes depending on how the services are billed on the claim forms
Pricing as of 12/1/22, subject to change throughout the year
Additional services may be billed separately if performed by outside providers

Discounted Cash Price
The charge that applied to an individual who pays cash or cash equivalent.

Payer-Specific Negotiated Charge
The charge that the hospital has negotiated with a third-party payer for the service
Reimbursement info as of 12/31/22, contracts renew and change at various points throughout the year

30 of the 70 required CMS shoppable services have not been performed at Alleghany Health so they are listed as “Services not Performed”

This information is provided as a guide to determine anticipated charges. The information is not a contractual agreement between the hospital and the consumer. Individual costs will be based on specific services provided. We advise that the consumer consult with their health insurer to confirm individual payment responsibilities and remaining deductible balances.

SHOPPABLE SERVICES

FULL CHARGEMASTER

Financial Assistance Program (FAP)

It is the policy of Alleghany Health to offer financial assistance in the form of free or discounted care based on need to patients and guarantors who are eligible for the Financial Assistance Program. Elective procedures, or those that are not medically necessary but are elected by the patient as a matter of convenience or choice, will not be eligible for financial assistance. For information on how we can help you determine if you qualify for financial aid in paying your bill, please click the links below.

Review Our Financial Assistance Program Effective 10/01/2020

Download The Financial Assistance Application

Medical Records

Our Health Information Management (HIM) Department is dedicated to acquiring, analyzing, and protecting your medical information including all of your personal medical records. We work closely with patients and families to provide this information upon request and in the most convenient and timely way possible.

To request a copy of your medical records, you will need to download and complete the Authorization for Use or Disclosure of Protected Health Information (linked below) and bring the completed form to medical records along with your drivers license or another valid ID. Please note that health information such as recent lab tests, doctors notes, immunizations, medications, etc. can be accessed through MyAlleghanyHealth,
your patient portal. For more information, please call 336-372-3107, Monday – Friday from 8 a.m. until 4:30 p.m.

Click here for Alleghany Health’s Authorization for Use or Disclosure of Protected Health Information (Release of Information)

Click here for Alleghany Family Medicine’s Authorization for Use or Disclosure of Protected Health Information (Release of Information)

Patient Feedback

At Alleghany Health, we are committed to providing the highest quality patient care in the safest environment possible. We have an established compliance committee that regularly reviews the practices and conduct of our staff and physicians. If you or a family member have any concerns or grievances during your stay – whether it involves patient care, safety or service – please let us know. Our customer service coordinator can be reached Monday – Friday from 8 a.m. – 4:30 p.m. at 336-372-3299.

Your Right to Receive a “Good Faith Estimate”

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059

Your Right and Protections Against Surprise Medical Bills

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency Services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services.

These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the U.S. Department of Health & Human Services at 1-800-985-3059 or by visiting www.cms.gov/nosurprises/consumers.

Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal