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White River Health (WRH) is a tax exempt organization committed to providing medical care for residents of North Central Arkansas. We will not refuse medically necessary services to any patient regardless of ability to pay for medical services.
We know most medical costs are unexpected, and understanding your medical bills can be complicated. The WRH financial team wants to help you meet your treatment needs. Our billing specialists and financial advocates are available to help answer your questions.
WRH accepts most major insurance plans. If you have any questions about your coverage or its applicability to WRH services, please contact your company's representatives.
WRH participates in a large number of commercial plans, PPOs, HMOs, and Workers' Compensation MCOs. We are continually growing and adding other networks to provide regional care to area residents. If you have a question about your coverage, call our Patient Financial Solutions Specialist for assistance at (870)262-1188.
WRH will bill your health plan on your behalf, including Medicare and Medicaid, for payment of hospital services. However, it is important to remember that you are ultimately responsible for payment of your hospital bill.
Many insurance companies require proper authorization, pre-certification and/or referrals. It is your responsibility to know what your insurance company requires and to obtain the proper authorization. WRH may ask you to pay any unmet deductibles, co-payments or other self-pay amounts that are due prior to the time of service or prior to discharge.
If you do not have health insurance or if you are experiencing financial difficulties paying your medical bills or you anticipate that you may not be able to pay your bill, WRH offers a financial assistance program. Financial Assistance is available for patients with limited incomes and who are uninsured or under-insured. Patients may be eligible to receive financial assistance for non-emergency, medically necessary services at WRH if they meet the income limits. The WRH Financial Assistance policy applies to all WRH facilities and employed providers. For more information about the financial assistance program, call our Patient Financial Solutions Specialist at (870) 262-1188.
FInancial Assistance ApplicationFinancial Assistance PolicyFinancial Assistance Application - Español
We know most medical costs are unexpected, and understanding your medical bills can be complicated. The White River Health (WRH) financial team wants to help you meet your treatment needs. Our billing specialists and financial advocates are available to help answer your questions.
Yes, our online payment service enables you to pay patient bills quickly, securely and conveniently. You can pay all or part of your bill online. There are no fees associated to paying your bill online or on the phone. We accept: Cash, Check, Debit, HSA/FSA, and most major Credit Cards.
When using our online bill pay system:
Yes, if you are unable to make an online payment, you are welcome to use traditional bill payment options via phone or mailing payment to:
PO Box 2197
Batesville, AR 72503
Office Hours: Monday - Friday, 8:00 am – 4:30 pm
Phone: (870) 262-3115 or (877) 235-9091
We will gladly work with all our patients for a better understanding of their WRH bill. Please contact us at (870) 262-3115 or (877) 235-9091 for an explanation.
We are also here to provide support and financial assistance if you are having trouble paying your bill. Please call (870) 262-1253 for help. We also offer the options of monthly payment plans and applying for financial assistance based upon family size and income.
Updated April 2020
CPT Code 87635/G2023
Cash Price: $79.60
To help patients prepare for medical expenses, White River Health has provided a link to hospital services and applicable standard charges. The charges for your hospital stay and your out-of-pocket costs depend on many factors including, your individual care needs, insurance coverage, deductibles, and co-insurance amounts.
The charges listed do not include professional fees charged by physicians and other health professionals such as the anesthesiologist, emergency room physician, hospitalist, pathologist, and/or radiologist who may provide consultation and care.
White River Health Patient Financial Advocates are available to assist you in understanding your hospital bill. Additionally, White River Health has financial assistance available for those who qualify. To obtain an estimate of charges and your financial responsibility for an upcoming hospital stay or outpatient procedure, please call 870-262-2929 Monday through Friday from 8 am to 4:30 pm. with your insurance information. Standard hospital charges are published in accordance with regulations established by the Center for Medicare and Medicaid Services and are subject to change without notice.
We know most medical costs are unexpected, and understanding your medical bills can be complicated. The White River Health (WRH) financial team wants to help you meet your needs. Our billing specialists and financial advocates are available to help answer your questions.
If paying your bill creates a financial burden or you believe the cost of your healthcare will be a financial burden, it is very important to let us know so we can help.
White River Health
(870) 262-1118
If approved, Financial Assistance reduces your WRH bill. Your financial assistance is only applicable for services received at WRH facilities and by WRH providers. How much it is reduced is based on established guidelines that include income level, medical condition, and other indicators of inability to pay. If you think you might qualify for assistance, we encourage you to contact us and apply.
You may be eligible for:
Financial Assistance is available for patients with limited incomes and who are uninsured or underinsured.
Patients may be eligible to receive financial assistance for non-emergency, medically necessary services at WRH if they meet the income limits.
If your income is equal to or less than 150% of the current Federal Poverty Guidelines and you meet the Financial Assistance Guidelines, you may be eligible for care at no cost to you. If your income is greater than 150% but not greater than 300% and you meet the Financial Assistance Guidelines, then you may be eligible for care at a reduced cost to you.
| Discount | 100% | 90% | 80% | 70% | 0% |
|---|---|---|---|---|---|
| Family Size/FPL | 150% | 200% | 250% | 300% | 400% |
| 1 | $23,475 | $31,300 | $39,125 | $49,950 | $62,600 |
| 2 | $31,725 | $42,300 | $52,875 | $63,450 | $84,600 |
| 3 | $39,975 | $53,300 | $66,625 | $79,950 | $106,600 |
| 4 | $48,225 | $64,300 | $80,375 | $96,450 | $128,600 |
| 5 | $56,475 | $75,300 | $94,125 | $112,950 | $150,600 |
| 6 | $64,725 | $86,300 | $107,875 | $129,450 | $172,600 |
| 7 | $72,975 | $97,300 | $121,625 | $145,950 | $194,600 |
| 8 | $81,225 | $108,300 | $135,375 | $162,450 | $216,600 |
Add $5,500 per family member exceeding eight(8).
If you cannot pay your bill, payment plans may be arranged with White River Health. Please contact us at 870-262-3115 or 877-235-9091 speak with a Billing Department representative.
| Required Supporting Documentation | Examples of Acceptable Documentation |
|---|---|
| Confirmation of Annual Income | Most Recent Federal Income Tax Return, Last 4 pay stubs, Most recent W-2 or 1099 Social Security Award Letter, Full Bank Statements for recent 3 months, Unemployment Statement Workers Compensation Award Letter, Pension or Retirement Statement Investment Income |
| Verification of Social Security Number and/or Date of Birth | Driver's License or State Issued Identification Card, Social Security Card, Birth Certificate, Baptismal Certificate, Military Discharge Papers, School Records |
| Verification of Residency | Mortgage Statement, Rental Agreement/Lease, Property Tax Bill, Room & Board Statement, Utility Bill, Written Verification from Landlord |
Return the above documentation to the Financial Office:
PO Box 2197
Batesville, AR 72503
Fax: (870) 262-6547
PO Box 510
Mountain View, AR 72560
Fax: (870) 269-6593
Costs will vary depending on the healthcare service rendered and the setting in which the care is delivered.
You may call us at (870) 262-2929 for an estimate.
The Financial Counselor can tell you if you qualify for free or low-cost insurance such as Medicaid. If the Financial Advocate finds that you do not qualify for low-cost insurance, they will help you apply for Financial Assistance to reduce your bill. The Financial Counselor will help you complete all the forms and tell you which documents you need to bring.
Financial Assistance PolicyFinancial Assistance Application
Eligibility for financial assistance is based on multiple factors, including the nature of the condition and care required, insurance coverage or other sources of payment (including personal injury claims), income (Federal Poverty Level guidelines used to determine the amount of financial assistance offered), family size, assets, and any special consideration the patient or physician would like to have considered.
Financial assistance is offered to patients who are uninsured and under-insured. Partial or full financial assistance will be granted based on a patient’s ability to pay the billed charges.
Patients must fully comply with the application process, including submitting tax returns, bank statements and pay stubs, as well as completing the application process for all available sources of assistance, including Medicaid or Medical Assistance.
The patient or any person involved in the care of the patient, including a family member or provider, can express financial concerns at any point during the patient’s care. The patient or responsible party will then be encouraged to complete a financial assistance application.
Financial assistance is limited to medical care provided at White River Health, Inc. facility locations and by White River Health, Inc. medical personnel. Expenses such as travel, food, lodging, durable medical equipment, and prescriptions are not covered under the Financial Assistance Policy. White River Health, Inc. will uphold the confidentiality and dignity of each patient, and any information submitted for consideration of financial assistance will be treated as protected health information under the Health Insurance Portability and Accountability Act (HIPAA).
Questions about Applying for Assistance
Should you have questions about applying for financial assistance please do not hesitate to ask any Patient Access Specialist, Financial Counselor or contact White River Health Business Office at (870) 262-1253.
A patient determined to be eligible for financial assistance may not be charged more than amounts generally billed for emergency or other medically necessary care to patients who have insurance for such care.
Translated versions of the application form, financial assistance policy, and this summary, are available upon request.
Revised: 07.22.2025
Effective: 08.01.2020
The Board of Directors of White River Health (WRH) is committed to the provision of financial assistance to patients who need care, have selected WRH for such care, and a determination has been made that the facility is the most appropriate facility for rendering such care of service and there is no other more suitable facility or program available to such patient where compensated care could be rendered. WRH follows federal guidelines in making reasonable efforts to determine a patient’s eligibility for financial assistance and utilizes federal poverty guidelines to inform financial assistance determinations.
This policy is approved and adopted by the WRH Board of Directors. It is necessary to adhere to an open door philosophy of furnishing adequate diagnostic and therapeutic services for emergencies to avoid claims of improper rejection, inappropriate transfers, or lack of recognition of cases requiring immediate attention in the emergency room. WRH conforms with existing Emergency Medical Treatment and Active Labor Act (EMTALA) laws and provides treatment for emergency medical conditions. Further, this policy prohibits WRH from engaging in actions that discourage treatment for emergency medical conditions or by permitting debt collection activities that interfere with the provision of emergency medical care.
The purpose of this policy is to ensure that requests for uncompensated service, reduced compensated services, and discount services are managed consistently, accurately, and timely.
These guidelines will be followed in providing financial assistance:
Each request for financial assistance will be evaluated on its own merits utilizing established patient accounts procedures based on this policy. Evaluation of the need for a particular patient may include such factors as:
Uninsured patients and patients who qualify for financial assistance will not be charged for emergency or other medically necessary care at rates higher than the “amounts generally billed” (AGB) to third-party payers. The use of gross charges to such patients is prohibited. For purposes of this policy, WRH uses the look-back method to determine the AGB; the look-back method is based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the facility during a prior 12-month period. The current AGB discount is 67% for Hospital-based Services, 61% for Professional and Specialty Services, and 20% for Primary Care and Behavioral Health Services.
Uncompensated/reduced compensation services will be limited to those patients whose family income is below 300% of the current national poverty guidelines. The prevailing national poverty guidelines will be the basis for determining eligibility and can be requested in writing, free of charge from the hospital or can be accessed at https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines.
Uncollectable accounts, accounts that were not reviewed by financial counselors at the time of service, and/or questionable collectible amounts may qualify for financial assistance during the collection process if they meet the above criteria.
In the following situations, a patient is determined as eligible for 100% reduction of charges:
WRH will provide a copy of the Financial Assistance Policy, Financial Assistance Application, and Billing & Collections Policy upon request, free of charge. The policy can be requested by calling WRH Patient Financial Counseling Office at 870-262-1188, or by mail at 1710 Harrison Street, Batesville, AR 72501. The Financial Assistance Policy and a Plain Language Summary of the Financial Assistance Policy is also available online at WhiteRiverHealth.org/pay-my-bill and at all points of the registration within the facility.
This Financial Assistance Policy applies only to WRH facility and professional charges where applicable and does not include charges that are not billed via WRH. This policy only applies to emergency and medically necessary services without discrimination and may not apply to elective procedures.
All approved financial assistance at WRH will be valid for six (6) months from the date of approval, unless a patient’s source of income is Social Security, then financial assistance will be valid for 12 months. All approved financial assistance will apply retroactively.
This policy will be applied equally to all patients regardless of payer source. Applications that do not meet the criteria set forth in our policy may, in extraordinary circumstances, be approved by the Chief Financial Officer.
WRH will provide care for emergency medical conditions and medically necessary services to individuals regardless of their ability to pay or eligibility for financial or government assistance, and regardless of age, gender, race, national origin, immigrant status, disabilities, sexual orientation, religious affiliation, or any other classification protected by federal, state or local law.
WRH provides financial assistance to persons who have received or will receive medically necessary care and/or emergent medical care and are uninsured, underinsured, ineligible for a government healthcare program or is otherwise unable to pay for the above services based upon their individual financial situation.
Eligibility for uncompensated services is limited to persons whose verifiable family income is equal to or less than 150% of the current poverty income guidelines as established by the Department of Health and Human Services.
Eligibility for reduced compensation services is limited to persons whose verifiable family income is greater than 150% of the current poverty income guidelines but not greater than 300% of the current poverty income guidelines as established by the Department of Health and Human Services.
Accounts that have been placed with a third-party collection agency are eligible for benefits provided requiring they meet appropriate guidelines. If approved, the account will remain with the collection agency but will receive the approved financial assistance reduction. All accounts placed with a third-party collection agency are eligible for a 35% settlement discount, upon request via patient or representative, if paid in full.
Acceptable household income verification for Financial Assistance Application may include:
For patients who do not qualify for financial assistance and choose not to pay their bill, WRH reserves the right to pursue collections activity on unpaid balances if the patient or representative does not meet the agreed upon schedule. These steps are outlined in the White River Health Billing and Collections Policy.
Exhibit 2:
| Balance | Month Term |
|---|---|
| $100-500 | 6 Month Maximum Term |
| $501-1,000 | 12 Month Maximum Term |
| $1,001-2,500 | 18 Month Maximum Term |
| $2,501-5,000 | 24 Maximum Term |
| $5,000+ See Financial Counselor for arrangements | |
Services covered under the WRH Financial Assistance Policy include White River Medical Center, Stone County Medical Center, professional fees provided in a hospital inpatient or outpatient setting and all WRH-owned clinics or other WRH-owned locations.
Approved financial assistance will be honored by all participating professional groups and clinics (as listed below). It is the patient’s responsibility to communicate approved financial assistance with the participating clinics as needed.
White River Health Professional Services
White River Health Primary Care & Behavioral Health Services
White River Health Specialty Services
White River Health
Patient Financial Counseling Office
1710 Harrison Street
Batesville, AR 72501
870-262-1188 Phone
870-262-6547 Fax
Department of Health & Human Services Poverty Guidelines
White River Health Billing & Collections Policy
White River Health Financial Assistance Policy & Poverty Table
Para calificar a recibir la asistencia financiera se estudia varios factores, incluyendo la clase de su condición y la atención requerida, cubertura de seguro u otros fuentes de pago (incluso reclamos de indemnización por daños corporales), sus ingresos (el lineamiento que define lo que es el Nivel de Pobreza Federal será utilizado para determinar la cantidad de asistencia financiera brindada), tamaño de la familia, bienes, y cualquier tema en particular que el paciente o el médico solicita que se toma en cuenta. La asistencia financiera se podría otorgar a los pacientes quienes no tienen seguro de salud o tienen seguro limitado. Asistencia financiera parcial o completo se otorgaría dependiendo de la capacidad del paciente de poder pagar los cobros facturados.
El paciente deberá colaborar completamente con el trámite de la solicitud, incluyendo la presentación de sus declaraciones de impuestos, estado de cuentas bancarias y talones de pago, tanto como cumplir los trámites para solicitar asistencia de otras fuentes disponibles, entre ellas Medicaid o Asistencia Médica.
El paciente u otra persona involucrada en el cuidado del paciente, incluyendo los parientes del paciente o un proveedor, puede expresarse preocupación financiera en cualquier momento durante el tratamiento del paciente. En aquel entonces, el paciente o la persona responsable por él será animado llenar una solicitud pidiendo asistencia financiera.
La asistencia financiera se limita a la atención médica brindada por los empleados de White River Health, Inc. únicamente en las instalaciones de White River Health, Inc. Los gastos como de viaje, comida, hospedaje, equipos médicos duraderos y medicina recetada no serán cubiertos por el Programa de Asistencia
Financiera. White River Health, Inc. protegerá la privacidad y dignidad de cada paciente, y toda información revelada para sostener la solicitud de asistencia financiera será tratada como información protocolizada según la ley HIPAA (Health Insurance Portability and Accountability Act).
Si tiene usted preguntas sobre como solicitar asistencia financiera, favor de consultarse de inmediato con un Representante de Servicio al Paciente, un Asesor Financiero, o comunicarse con un funcionario de la oficina de Gestión de White River Health al (870) 262-1253.
Un paciente quien califica por la asistencia financiera no será cobrado más de los montos generalmente cobrados por servicios de emergencia u otros servicios médicos necesarios en comparación con el monto cobrado a los pacientes quienes tienen seguro de salud.
Hay versiones traducidas a otros idiomas de: la solicitud, la política sobre asistencia financiera, y este resumen; todos los cuales están disponibles a petición.