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Diley Ridge Medical Center is a community of persons serving together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Aligned with our Core Values, in particular that of Commitment To Those Who Are Poor, we provide care for persons who are in need and give special consideration to those who are most vulnerable, including those who are unable to pay and those whose limited means make it extremely difficult to meet the health care expenses incurred. Diley Ridge Medical Center is committed to:
Download our Patient Financial Assistance Policy.
Application Period - Begins the day that care is provided and ends the later of 240 days after the first post-discharge billing statement is provided to the patient or either --
Amounts Generally Billed ("AGB") - The amounts generally billed for emergency or other medically necessary care to patients who have insurance covering such care, Diley Ridge Medical Center's acute and physician AGB will be calculated utilizing the look back methodology of calculating the sum of paid Medicare claims divided by the total or “gross” charges for those claims by the System Office or Diley Ridge Medical Center annually using twelve months of paid claims with a 30 day lag from report date to the most recent discharge date.
Discounted Care - A partial discount off the amount owed for patients that qualify under the FAP.
Emergent (service level) - Medical services needed for a condition that may be life threatening or the result of a serious injury and requiring immediate medical attention. This medical condition is generally governed by Emergency Medical Treatment and Active Labor Act (EMTALA).
Executive Leadership Team ("ELT") - The group that is composed of the highest level of management at Trinity Health.
Extraordinary Collections Actions ("ECA") - Include the following actions taken by Diley Ridge Medical Center (or a collection agent on their behalf):
Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient’s nonpayment of one or more bills for previously provided care covered under the hospital facility’s FAP. If Diley Ridge Medical Center requires payment before providing care to an individual with one or more outstanding bills, such a payment requirement will be presumed to be because of the individual’s nonpayment of the outstanding bill(s) unless Diley Ridge Medical Center can demonstrate that it required the payment from the individual based on factors other than, and without regard to, his or her nonpayment of past bills.
Family - As defined by the U.S. Census Bureau, a group of two or more people who reside together and who are related by birth, marriage, or adoption. If a patient claims someone as a dependent on their income tax return, according to the Internal Revenue Service rules, they may be considered a dependent for the purpose of determining eligibility under the Diley Ridge Medical Center’s financial assistance policy.
Family Income - A person’s family income includes the income of all adult family members in the household. For patients under 18 years of age, family income includes that of the parents and/or step-parents, or caretaker relatives. Annual income from the prior 12 month period or the prior tax year as shown by recent pay stubs or income tax returns and other information. Proof of earnings may be determined by annualizing the year-to-date family income, taking into consideration the current earnings rate.
Financial Assistance Policy (FAP) - A written policy and procedure that meets the requirements described in §1.501(r)-4(b).
Financial Assistance Policy ("FAP") Application - The information and accompanying documentation that a patient submits to apply for financial assistance under Diley Ridge Medical Center's FAP. Diley Ridge Medical Center may obtain information from an individual in writing or orally (or a combination of both).
Financial Support - Support (charity, discounts, etc.) provided to patients for whom it would be a hardship to pay for the full cost of medically necessary services provided by Diley Ridge Medical Center who meet the eligibility criteria for such assistance.
Free Care - A full discount off the amount owed for patients that qualify under the FAP.
HCAP - A state and federal program maintained by the Ohio Department of Job and Family Services to comply with a federal requirement to implement additional payments through the disproportionate share (DSH) program to hospitals that provide a disproportionate share of uncompensated services to indigent and uninsured Ohioans who are at or below 100% of the current Federal Poverty Guideline Level and who are ineligible for Medicaid.
Income - Income includes wages, salaries, salary and self-employment income, unemployment compensation, worker’s compensation, payments from Social Security, public assistance, veteran's benefits, child support, alimony, educational assistance, survivor's benefits, pensions, retirement income, regular insurance and annuity payments, income from estates and trusts, rents received, interest/dividends, and income from other miscellaneous sources.
Medical Necessity - Is defined as documented in the State of Ohio's Medicaid Provider Manual.
Policy - A statement of high-level direction on matters of strategic importance to Trinity Health or a statement that further interprets Trinity Health’s governing documents. System Policies may be either stand alone or Mirror Policies designated by the approving body.
Plain Language Summary of the FAP - A written statement that notifies a patient that the hospital facility offers financial assistance under a FAP and provides the following additional information in language that is clear, concise, and easy to understand:
Procedure - A document designed to implement a Policy or a description of specific required actions or processes.
QHP - An insurance plan that is certified by the Health Insurance Marketplace, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements under the Affordable Care Act, starting in 2014. A qualified health plan will have a certification by each Marketplace in which it is sold.
Regional Health Ministry ("RHM") - A first tier (direct) subsidiary, affiliate or operating division of Trinity Health that maintains a governing body that has day-to-day management oversight of a designated portion of Trinity Health System operations. RHMs may be based on a geographic market or dedication to a service line or business.
Service Area - The list of zip codes comprising Diley Ridge Medical Center’s market area constituting a “community of need” for primary health care services. (See attachment “A”)
Standards or Guidelines - Additional instructions and guidance which assist in implementing Procedures, including those developed by accreditation or professional organizations.
Subsidiary - A legal entity in which Diley Ridge Medical Center is the sole corporate member or sole shareholder.
Uninsured Patient - An individual who is uninsured, having no third-party coverage by a commercial third-party insurer, an ERISA plan, a Federal Health Care Program (including without limitation Medicare, Medicaid, SCHIP, and CHAMPUS), Worker’s Compensation, or other third party assistance to cover all or part of the cost of care, including claims against third parties covered by insurance to which Diley Ridge Medical Center is subrogated, but only if payment is actually made by such insurance company.
Urgent (service level) - Medical services for a condition not life threatening, but requiring timely medical services.
Diley Ridge Medical Center’s Financial Assistance Policy (FAP) is designed to address the need for financial assistance and support to patients for all eligible services regardless of race, creed, sex, or age. Eligibility for financial assistance and support is determined on an individual basis using specific criteria and evaluated on an assessment of the patient’s and/or family’s health care needs, financial resources and obligations.
All other assets will be considered available for payment of medical expenses. Available assets above a certain threshold can either be used to pay for medical expenses (or alternatively count excess available assets as current year income in establishing the level of discount to be offered to the patient). A minimum amount of available assets should be protected. The minimum amount is currently set at $5,000.
Facility Name | Total Medicare Charges (A) | Total Medicare Contractual (B) | Medicare Discount Rate (B/A) |
Mount Carmel East | $294,718,702 | $225,619,218 | 76.6% |
Mount Carmel Grove City | $126,704,702 | $95,800,902 | 75.6% |
Mount Carmel St. Ann's | $173,875,096 | $133,445,809 | 76.7% |
Mount Carmel New Albany | $88,560,291 | $66,736,598 | 75.4% |
Diley Ridge Medical Center | $6,022,372 | $4,562,462 | 75.8% |
It is recognized that occasionally there will be a need for granting additional financial support to patients based upon individual considerations. Such individual considerations will be approved by the Diley Ridge Medical Center CFO or his designee.
Should any provision of this FAP conflict with the requirement of the law of the state of Ohio, Ohio state law shall supersede the conflicting provision and Diley Ridge Medical Center shall act in conformance with applicable state law.
This procedure applies to all Trinity Health RHMs that operate licensed tax-exempt hospitals. Trinity Health organizations that do not operate tax-exempt licensed hospitals may establish their own financial assistance procedures for other health care services they provide and are encouraged to use the criteria established in this FAP procedure as guidance.
This Procedure is based on a Trinity Health “Mirror Policy.” Thus, all Trinity Health RHMs and Subsidiaries that operate licensed tax-exempt hospitals are required to adopt a local Procedure that “mirrors” (i.e., is identical to) the System office Procedure. Questions in this regard should be referred to the Trinity Health Office of General Counsel.
Further guidance concerning this Procedure may be obtained from the VP, Revenue Cycle, in the Revenue Excellence Department.
Please choose your language below to access the correct financial assistance application:
Click the links below to view a list of providers who are covered by Diley Ridge's Financial Assistance Policy.
In the spirit of our mission to serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities, Diley Ridge Medical Center is committed to providing healthcare services to all patients based on medical necessity.
For patients who require financial assistance or who experience temporary financial hardship, Diley Ridge Medical Center offers several assistance and payment options, including charity and discounted care, short-term and long-term payment plans and online patient portal payment capabilities.
Diley Ridge Medical Center extends discounts to all uninsured patients who receive medically necessary services. Uninsured discount amounts are based on Federal Poverty Level (FPL) guidelines. Patient statements will show the discount amount and the adjusted balance owed. All medically necessary services qualify for uninsured discounts. Diley Ridge Medical Center may qualify patients based on residency requirements.
Services such as cosmetic procedures, hearing aids and eye care that normally are not covered by insurance are priced at packaged rates with no additional discount. All payments are expected at the time of service.
Patients who cannot pay some or all of their financial responsibility may qualify for short-term or long-term payment plans. Diley Ridge Medical Center’s short-term payment plan is interest-free and patient balances must be paid in full within one year. Longer term interest-bearing payment plans are available through HealthFirst Financial Services for those patients who cannot pay their balances within one year.
A 100 percent discount for medically necessary services is available to patients who earn 200 percent or less of the Federal Poverty Level guidelines. Elective services such as cosmetic surgery are not included in our charity program. Those who earn between 201 and 400 percent of the Federal Poverty Level guidelines may be eligible for a partial discount equal to the Medicare discount rate. Patients who qualify for financial assistance will not be charged more than the Medicare discount rate.
Patient copays and deductibles may be eligible for discounted rates if a patient qualifies for financial assistance and earns less than 200 percent of the Federal Poverty Level Guidelines.
Discounts are also available for those patients who are facing catastrophic costs associated with their medical care. Catastrophic costs occur when a patient’s medical expenses for an episode of care exceed 20 percent of their annual income. In these cases, patient copays and deductibles may also be included in the discount.
Charity care discounts may be denied if patients are eligible for other funding sources such as a Health Insurance Exchange plan or Medicaid eligibility and refuse or are unwilling to apply for these sources.
Financial counselors are available to work with patients in completing financial assistance applications to determine what assistance is available. This includes assessing eligibility for Medicaid and Health Insurance Exchange plans.
Patients may contact a financial counselor at the hospital where they have care who can assist in determining qualifications for financial assistance. Financial counselors can also provide free copies of the Financial Assistance Policy, Application, and Plain Language Summary. Free copies can also be obtained by writing to the MCHS Customer Service Dept, 6150 East Broad St. Columbus, OH 43213, PH# 800-346-1009.
The Financial Assistance Policy, Application and Plain Language Summary are translated into the following languages: Spanish, Somali, Nepali, Chinese, Arabic, French, Mandarin, Japanese, Russian, Korean, and Vietnamese. No patient who qualifies for financial assistance will be charged more than the amounts generally billed by the hospital, which are Medicare rates.
The Affordable Care Act (ACA) requires everyone legally living in the U.S. to have health insurance beginning January 1, 2014. It also gives millions of individuals with too little or no insurance, access to health plans at different cost levels. The law also provides financial assistance to those who qualify based on family size and income. Please see a financial counselor at the facility where you receive care for more information.
Beginning October 1, 2013, you will be able to shop at a new online Health Insurance Marketplace, also known as a health insurance exchange, where you can one-stop-shop for a plan that fits your budget and coverage needs. The next open enrollment for the health insurance marketplace is anticipated each November.
Diley Ridge Medical Center transitioned to a new patient portal, called MyChart, in October 2021. You can still access your historical medical information from MyDileyRidge. However, you will only be able to view and read the information on MyDileyRidge; you will not be able to communicate with your provider and no new information will be added. For more information, please visit our Frequently Asked Questions page.
If you received a statement with a date of service prior to October 9, 2021, please use the information below to make a payment.
To pay your bill by phone, please call 614-546-4400.
Pay Your MyDileyRidge Bill Online
If you received a statement with a date of service on or after October 9, 2021, please use the information below to make a payment.
All patient bills can be paid through your new patient portal, MyChart. You can learn more about MyChart by visiting our MyChart FAQs page. For your convenience, we accept Visa, MasterCard, Discover and American Express.
Questions? Please call MyChart customer support at 844-805-4357.
At Diley Ridge, our screening and diagnostic mammograms are performed using advanced digital technology, and are read and interpreted by dedicated, fellowship-trained radiologists with the highest level of skill.
For women with dense breast tissue, we also offer an advanced, FDA-approved screening called tomosynthesis, which uses a series of x-rays to create a comprehensive, 3D image of the breast to identify smaller lesions that are harder for a traditional mammogram to detect.
Scheduling your appointment is easy and no referral is necessary. Simply click fill out our request form below.
You can let us know you’re on your way to Diley Ridge Medical Center with online check-in. It’s quick and easy. Just fill out the form below and we'll know to expect you.
It’s important to remember that we will still need to see patients in order of severity. But providing us with your information prior to arrival can help us make your trip to Diley Ridge even more efficient. And that's something to appreciate when you're not feeling well.
At Diley Ridge, our screening and diagnostic mammograms are performed using advanced digital technology, and are read and interpreted by dedicated, fellowship-trained radiologists with the highest level of skill.
For women with dense breast tissue, we also offer an advanced, FDA-approved screening called tomosynthesis, which uses a series of x-rays to create a comprehensive, 3D image of the breast to identify smaller lesions that are harder for a traditional mammogram to detect.
Scheduling your appointment is easy and no referral is necessary. Simply click fill out our request form below.