Calhoun Liberty Hospital

Patient Financial Services

The Calhoun-Liberty Hospital Business Office is open Monday through Friday from 8:00am to 4:30pm CST to assist you with your financial needs.

Calhoun-Liberty Hospital and its staff are dedicated to serving the community’s healthcare needs.

As a not-for-profit hospital we provide emergent services and most medically necessary services regardless of financial status or the patient’s ability to pay.

Payment on accounts will be pursued consistently, without discrimination.

“You may follow the links below to review available discounts, policies and procedures.

Hospital Patients
Discounts offered to Non-Insured Patients off outstanding account balances
Discounts Offered to Emergency Room Non-Insured Patients

Clinic Patients
Payment Policy for Insured Patients of Calhoun-Liberty Primary Care Clinic
Payment Policy for Non-Insured Patients of Calhoun-Liberty Primary Care Clinic

Employee Discounts
Calhoun Liberty Hospital Employee Discounts
Calhoun-Liberty Hospital Insured Full-time Employees Account Write-offs

Collection Procedures
Bad Debt & Medicare Bad Debt Collection Policy

In the event a patient is unable to pay we offer financial assistance options.

Financial Assistance / Charity Care

How to Request Assistance:

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

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 for review.

business

What to Expect:

Your application will be reviewed and a decision will be communicated to you. All information is confidential. Eligibility is calculated based on the Federal Poverty Guidelines and the indicators listed below.

  1. Family Size
  2. Income Guidelines
  3. Assets
  4. Expenses

See the Financial Assistance Policy links below for full details.
Please Note: The hospital and clinic have different policies and requirements.

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

If you have questions or need assistance completing the application please contact the hospital business office.

Financial Transparency

Standard Charges

A list of Calhoun-Liberty Hospital’s standard charges can be found in the link below.
Charge Master Listing

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 Mission to Care website.

Visit MissionToCare.org for more information.

Personalized Estimate

You as a patient or prospective patient have the right to request a personalized estimate of charges from our hospital, which will be provided within 7 business days from receipt of the request. Unless you request a more personalized estimate, the estimate may be based upon the average payment received for the anticipated service bundle.

If you would like to receive a personalized estimate, please contact the Business Office at (850) 237-3025.

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 FloridaHealthPriceFinder.
For information on service bundles, please visit FloridaHealthPriceFinder.com

Additional Practitioners or Service Providers

You should contact any health care practitioners or contracted service providers anticipated to provide services to you while in the hospital regarding an estimate of their cost, billing practices, and participation with the patient’s insurance provider or HMO, as they may not participate with the same health insurers or HMO as the hospital.

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

Dr. Iqbal A. Faruqui, MD
Medical Center of Blountstown
20454 NE Finley Ave
Blountstown, FL 32424
Phone: (850) 674-2221

Dr. Misbah I. Farooqi, MD
Medical Center of Blountstown
20454 NE Finley Ave
Blountstown, FL 32424
Phone: (850) 674-2221

For Radiology Readings:
Coastal Radiology Associates, LLC
722 Newman Road
PO Box 12065
New Bern, NC 28561
Phone: 252-633-5057
Fax: 252-633-0084
Billing department: 888-477-2676

For Echocardiogram Readings:
Richard M. Christopher, MD
Internal Medicine Associates
4318 5th Ave
Marianna, FL 32446
Phone: 850-526-5300
Fax: 850-526-5001

Accepted Insurance Plans

The following is a list of websites for health insurers that Calhoun-Liberty Hospital is contracted with.

Please note that Calhoun-Liberty Hospital may not be included in all health plan product offerings.

If you do not see your insurance plan listed below you may call our business office at 850-237-3025 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

Prestige
www.prestigehealthchoice.com

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