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Help is available for navigating medical bills


For many people, receiving a bill after a doctor’s visit or a hospital stay can be shocking and confusing. The role of Bothwell Regional Health Center’s Patient Financial Services is to help provide price transparency, assist patients in navigating their bills and offer financial help if needed. 

“When patients preregister for most services, we provide them with an estimate,” said Diana O’Connor, Patient Financial Services director. “We want to help patients be aware of what their out-of-pocket expenses could be so when they get their bill, there are fewer surprises.”

Medical bills are unlike most expenses because patients often have little or no control over costs due to an illness or accident.

“Costs because of Emergency Department visits are especially difficult because they were not expected or budgeted,” O’Connor said. “People don’t plan for a trip to the emergency room.” 

In the event patients don’t have insurance or enough insurance to pay their bills, Bothwell offers several ways to help. Options include discounts for bills paid up front or in full when due, a payment plan, loan programs, and charity care.

“We provide a 12-month payment plan with minimum payments of $50 per month,” O’Connor said. “If someone is unable to pay the bill within 12 months, we offer a three-year, interest-free loan program up to $15,000 with Central Bank of Sedalia.” 

According to Larry Bahr, Central Bank CEO and president, the loan program was created in 2014 at Bothwell leadership’s request as another option to help patients pay for high deductibles or remaining balances. Since its creation, more than $6 million has been loaned to patients. About 500 loans are issued annually, and the average loan is $3,000.

“I am proud that we created the program, and that it’s working,” Bahr said. “It helps the community, which is a good thing.”

Bahr said the bank recently expanded the program to add a larger loan of up to $30,000 for five years. The first three years are interest free.

“This option may allow people to pay for procedures not covered by insurance or a bill because someone doesn’t have insurance,” he said. 

O’Connor said Bothwell has seen an uptick in patients with no insurance.

“There has been a significant increase in ‘self-pay’ patients,” she said. “That can be attributed to the fact that the Affordable Care Act is no longer mandatory and that Missouri only recently expanded Medicaid coverage.” 

As a result of the increase in self-pay patients, Bothwell created a Patient Financial Advisor position in July 2019 and hired Holli Bircher. She works with the hospital’s Patient Financial Services and Medical Social Services to assist patients while they are still in the hospital. 

Bircher is a certified medicine technician and has an insurance background as a former district manager for an assisted living group, making her ideally suited to understand patients’ clinical and financial issues. 

“The position is intentionally invasive in that I visit patients in their rooms and learn about their lives and financial needs,” she said. “So, whether they have private or marketplace insurance or don’t have insurance, my job is to help them.”

One resource Bircher might recommend is charity care, which is free or discounted health care to patients who meet federal poverty guidelines. 

“Many people don’t realize that Bothwell offers charity care and that they might be eligible for it; it’s a service that we would like more people to apply for,” she said. “Some people don’t want charity or a handout, or even help, but it’s my job to tell them what resources are available and find out if they qualify.”

Bircher also assists patients by researching local and national foundations and charities to identify funds to help pay medical bills or provide medical equipment. She helps patients apply for Medicaid, assists with Medicare and Medicaid appeals, and answers questions. Bircher recently started working with other organizations in the community to help be a resource for others to learn about various health care coverages. 

“Navigating Medicare, Medicaid and insurance plans can be time consuming and confusing,” she said. “I am a resource for our patients. I recently worked with a foundation to get funds to help patients without transportation to be able to leave the hospital. I also know the hospital’s payment plan guidelines, and I can help facilitate the Central Bank loan program or work with the Bothwell Foundation for a patient’s financial needs.”

For O’Connor, the overall goal of Patient Financial Services is to have as many options for patients as possible. 

“Every patient has a different situation,” she said. “It’s important that we understand that and let people know they can talk to us (Financial Services staff) and work with Holli to find out what options are available. It’s better to do that than ignore a bill that could go to collection. We want to help patients as much as possible.” 


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