Patient Financial Services

Calhoun Liberty Hospital is committed to meeting the needs of the community. As a not-for-profit system, CLH provides non-elective services to patients without regard to financial status or ability to pay. At the same time, CLH relies on income from patients to reinvest in clinical programs aimed at strengthening and promoting the health of the community. We ask that you cooperate in meeting your financial obligation to CLH. If you need assistance with your medical bill at CLH, or, if you would like to apply for financial assistance, please contact us at:

Patient Financial Services
20370 NE Burns Ave
Blountstown, FL 32424
Phone: 850-674-5411
Hours: Monday through Friday, 8:00 a.m. – 4:30 p.m.

Shondel Frear, CCT, CRCS

Revenue Cycle Manger

Billing Process

The billing process begins when you register for services at the hospital or, have an appointment with your physician or provider at our CLH clinic. You will be asked to provide any health insurance information or other insurance information such as auto or workman’s comp if applicable, at the time of service.

As a courtesy, we will bill your insurance company directly. Depending on the insurance you have, you may be asked to pay your portion such as a specific co-payment, co-insurance or deductible amount as your share of the cost.

Your insurance coverage is an agreement between you and your insurance company. Please be sure to refer to your insurance policy guidelines and benefit information with questions about your coverage.

Once your insurance has processed the claim, you will receive a statement for any patient balance due. If you have questions, please contact Patient Financial Services at 850-674-5411. If you are unable to pay the bill in full, a payment plan may be established. If you are unable to pay your bill, you may qualify for financial assistance. Please refer to the section titled Financial Assistance for more information.

Types of Insurance Accepted by CLH

Calhoun Liberty Hospital accepts most insurance types (see below for a list of participating providers). If CLH is a participating provider, your insurance will receive a discount based on a contract with CLH. We bill the insurance provider on your behalf. Any amount indicated as patient responsibility after your insurance has paid will be billed to you. If CLH is not a participating provider by contract with the insurance company, you will be responsible for any amount not paid by your plan. In addition, you may receive services at CLH by independent providers, such as radiologist, pathologist or emergency room physicians. Please note that hospitals may not be included in all health plan offerings. Please check with your insurance company for more information.

Independent physicians may bill you separately. You should contact your insurance plan to determine if these providers are in network or, participating with your plan.  A list of provider groups that offer services independent of CLH may be found below (list of independent providers).

Calhoun Liberty Hospital Association, Inc. participates with government-sponsored plans such as Medicare, Medicaid, Tri-Care and Veterans Administration. Regardless of the type of coverage, it is your responsibility to provide an insurance card at the time of registration so a claim can be submitted to your plan.

It is your responsibility to ensure we have accurate, current insurance information on file. If you provide insurance information after the time limit for filing has passed, the bill may be your responsibility.

Private Insurance Plans Accepted

Please see the list below of private insurance plans we are participating providers for at Calhoun Liberty Hospital, Inc. If you do not see your plan listed below, please call us at 850-674-5411 to see if we accept your plan.

Aetna www.aetna.com

BlueCross and BlueShield of Florida www.floridablue.com

Capital Health Plan www.capitalhealth.com

Centurion provider.centurionmanagedcare.com

Cigna www.cigna.com

Clear Health Alliance www.clearhealthalliance.com

Covenant Hospice www.choosecovenant.org/hospice

Coventry coventryhealthcare.com

Emerald Coast hospice emeraldcoasthospice.org

Humana www.humana.com

Humana Military www.humanamilitary.com

Magellan www.magellanhealth.com

Florida Medicaid www.medicaid.gov

Medicare www.medicare.gov

Prime Health Services www.primehealthservices.com

Simply Healthcare www.simplyhealthcareplans.com

Staywell florida.wellcare.com/member/florida_staywell

Sunshine Health www.sunshinehealth.com

Three Rivers Provider Network www.threeriversagency.net

Tricare www.tricare.mil

United Healthcare www.uhc.com

Wellcare www.wellcare.com/Florida

No Surprises Act

Your Rights and Protections Against Surprise Medical Bills

Financial Assistance / Charity Care

Calhoun Liberty Hospital is committed to meeting the healthcare needs of the community. As a not-for profit hospital, CLH provides emergency and medically necessary services to all patients without regard to status or ability to pay.

If you anticipate any difficulty in paying your hospital or clinic bill, or, if you would like to apply for financial assistance, please contact our Patient Financial Services representative at, 850-237-3025
Monday – Friday 8 am to 4:30 pm. 

How to Request Assistance:

Begin by obtaining a Financial Assistance Application from any of the following methods:

• Click here to download the Financial-Assistance-Application

• Hospital Financial Assistance Policy
• Financial Assistance Policy for Calhoun-Liberty Primary Care Clinic

You may also obtain a paper copy of the financial assistance policy and application form at any registration location of the hospital, CLH Clinic or, the Business Office.

Once you Complete and return the Financial Assistance Application with all the applicable documentation indicated (the most recent copies of your W-2, Tax Returns, Pay Stubs and Bank Statements) to the business office the application will be reviewed. CLH uses the Federal Povert Guidlines issued by the U.S> Department of Health and Human Services to determine a patient’s eligbility for financial assistance. If the application is approved, the applicant will be notified within 30 calendar days of receipt of a completed application.

Contacting the Financial Assistance Program at CLH

Patient Financial Services representatives are available to assist you in understanding the financial assistance program and to answer any questions you may have. Should you need assistance in any other language besides English, the program may be able to provide a translator for you. The financial counselor will also be able to assist or inform you of other programs such as Medicaid, Disability and Vocational Rehabilitation Services that may assist you with your hospital bill. Our financial counselors will also be able to direct you to healthcare navigators within our community that can assist you with finding insurance through the market-place exchange.

Self-Pay Discounts

Calhoun Liberty Hospital offers self-pay discounts to uninsured patients. Please see our Self-Pay Discount Policy for more information by clicking this link. Self-Pay Discount Policy

Financial Transparency

Standard Charges

AHCA’s Florida Health Price Finder provides estimated payments for over 200 bundles of care, showing the payment information by each component of care. Health plan claims data are the source for the data on the pricing website.

Click here to access the Florida Health Price Finder

You can also view and compare hospital prices for certain services on the Florida Hospital Association’s website MissionToCare.org for more information.

In compliance with the CMS Price Transparency rules effective on 01/01/2022, please click the link below that applies to you.

Down Hospital Machine Readable File

https://www.calhounlibertyhospital.com/wp-content/uploads/2023/03/593051173_calhoun-liberty-hospital_disclaimer.csv

Personalized Estimate

You as a patient or prospective patient have the right to request a personalized estimate of charges from our hospital.  The estimate may be based upon the average payment received for the anticipated service bundle.

*** Click here to start your estimate. ***

*** If you would like to receive a detailed personalized estimate that takes into account your coordination of benefits, please contact the Business Office at (850) 674-5411.

Service Bundles

Service bundles are non-personalized estimates of costs that may be incurred for hospital services, and include all components of care, such as physician, ancillary and hospital payments. Actual costs will be based on services actually provided, and may be more or less than the estimates found on Florida Health Price Finder.
For information on service bundles, please visit FloridaHealthPriceFinder.com

Additional Practitioners or Service Providers

For charge estimates and billing questions, please contact the health care practitioners who may provide Emergency Department services and Radiologist services to the you while in the hospital. These contracted physicians may or may not participate in the same insurance plans that Calhoun Liberty Hospital participates in. You may contact the respective physician group to verify if the practitioners accept your specific insurance or health maintenance organization (HMO).

Contact Information for health care practitioners or medial practice groups that may bill separately for services provided at Calhoun-Liberty Hospital:

For Hospitalist and Emergency Physician services:
Envision Physician Services
350 West Cedar Street
Pensacola, FL 32502
Phone: 888.513.6044
emcare.com Contact Page
Physicians participating in this group:

• Dr. Timothy Adamcryk
• Dr. Misbah Farooqi
• Dr. Kristen Nava
• Dr. John Griffin
• Dr. Murray Baker
• Dr. Lee Gibson
• Dr. Hantz Hercule
• Dr. Jeffrey Johns
• Dr. Mary Anania
• Dr. Val Sheffield
• Dr. Joseph Heflin
• Dr. Emmanuel Tanglao

For Ambulance Service Billing

Calhoun County EMS

20382 NW Penning Ave, Blountstown, FL 32424

Billing inquiries:

For Dates of Service After 8/1/2022: AMB-EMS 1-844-899-7701 or email: Questions@AMB-EMS.com

Pay Your Bill

For Dates of Service Prior to 8/1/2022 please call EMS Consultants at1-800-342-5460

For Radiology Readings:
Radiology Partners
2300 Utah Avenue Suite 200 El Segundo, CA 90245

For Estimates and other Fee requests email feerequests@radpartners.com

Financial Assistance Fax (424)500-8592 or email financialassistance@radpartners.com
Billing inquiries: (904)236-5884 or ptcollections@radpartners.com
Pay your bill online by clicking here.

Physicians participating in this group:

First Name Last Name,
Julio Cordero, MD
Jennifer Cranny, MD
Kaamal Massis, MD
Chen QiXin, MD
Kristin Alman, DO
Eman Kalboush, MD
Raymond Perez, DO
Ronald Stengel, DO
Ghizlane Bahij, MD
Kelly Fabrega-Foster, MD
Alexander Le, MD
Katie Lester, MD
Fernando Viana, MD
Michael Breen, MD
David Rosenberg, MD
Jeffrey Jones, MD
Jesus Pereyra, MD
Jack Lyons, MD
Mamdoug Rayan, MD
Valerie D’Aurora, MD
Sarvenaz Pourjabbar, MD
Joshua Blackmon, MD
Emily Joyce, MD
Penny Roumanis-Johnson, MD
Gordon Hixson, MD
Glenn Kaplan, MD
Steven Zheng, MD
David Samuelson, MD
Aaron Hattaway, MD
Jim Gray, MD
Pervez Siddiqui, MD
Jonathan Kass, MD
Jay Webb, MD
Nicholas Waddell, MD
Cynthia Bloom, MD
Matthew Peterson, MD
Donald Nies, MD
Richard Lastrapes, MD
Scott King, MD
Harpreet Grewal, MD
Cain Green, MD
Lee Friedman, MD
Warren Cohen, MD
Kenneth Baker, MD
Jamie Ledford, MD
Brian Scanian, MD
Vincent Berney, MD
Christopher Murray, MD
Scott Lehto, MD
Adbel Beidas, MD
Nalini Reddy, MD
Sana Naeem, MD
Barta Thomas, MD
Paul Karlinsky, MD
Juan Camacho, MD
Andrew Kozlov, MD
Richard Amato, MD
Bryan Hamade, MD
Jamil Shaikh, MD
Berthina Coleman, MD
Scott Anderson, MD
Gregg Baran, MD
Hadi Bazzi, MD
Marc Camacho, MD
Hemant Chheda, MD
Chad Engel, MD
Marilin Espino-Maya, MD
John Feldman, MD
Travis Foster, MD
David Germain, MD
JoAnn Gierbolini, MD
Hugo Montes, MD
Ryan Harvey, MD
Jasmin Harvey, MD
Gus Mitsopoulos, MD
Douglas Ivancsits, MD
Rajendra Kedar, MD
Todd Kumm, MD
Juan Lee, MD
Richard Lichtenstein, MD
Ashley Maru, MD
Ryan Murtagh, MD
Leelakrishna Nallamshetty, MD
Ajay Pancholy, MD
Bharatkumar Patel, MD
David Picca, MD
Huang David, MD
Nisha Rao, MD
Mark Rieumont, MD
Douglas Rodriguez, MD
Eric Tirnauer, MD
Jeffrey Wasserman, DO
Robert Zamore, MD
Bret Neiderman, MD
Hugo Montes, MD
Gabriel Werder, MD
Laurence Grundy, MD
Richard Shepler, MD
Anthony Alioto, MD
Lori Barr, MD
Christopher Keup, MD
Richard Sibley, MD
Richard Bonney, MD
Nicholas D’Alesio, MD
Leonard Estevez, MD
Salvatore Grasso, MD
Adam Green, MD
Raymond Radanovich, MD
Sonali Ranjit, MD
Margo Roca, MD
Albert Sohn, MD
Billy Blackmon, MD
Fang-Yun Gan, MD
George Antaki, MD
Joel Heitman, MD
Glenn Hoots, MD
Clifford Davis, MD
Samuel Shube, MD
Bryant Thorpe, MD
Edward Oif, MD
Timothy Zelenak, MD
Shawn Meader, MD
Alan Ericksen, MD
Venetia Vassiliades, MD
Sandy Shultz, MD
Ted Harb, MD
Laura Laudrieu, MD
Michael Herron, MD
Todd Kaplan, MD
Scott Marlowe, MD
Steven Portale, MD
James Zimmerman, MD
Hristina Natcheva, MD
Reuben Trane, MD
Ryan Leahy, DO
Emily Joyce, MD
Carmela Gonzales, MD
Zianka Fallil, MD
Frederic Siore, MD
Michael Wolf, MD
Gregg Zoarski, MD
Charles Gordon, MD
Morgan Eckerd, MD
Moayad Tarboush, MD
Satish Venkataperumal, MD
Joseph Sullivan, MD