Patient Rights and Responsibilities
San Antonio Community Hospital has adopted Patient Rights and Responsibilities
in accordance with Section 70707 of the California Administrative
Code and the Centers for Medicare and Medicaid Services (CMS), Conditions of Participation. For
a complete description of these rights and responsibilities, please
click the icon:
If you need Adobe Acrobat in order
to read the file, click here.
Advance Beneficiary Notice
A limited number of non-emergency outpatient tests are not covered by
the Medicare Program. If your physician orders a non-covered test, you
will be asked to sign an Advance Beneficiary Notice (ABN) agreeing to
accept financial responsibility for the non-covered test. Click
here to view a copy of the ABN.
If you refuse to sign the ABN, the test will not be performed. It is
important for you to consult with your physician before making this
decision. Only your physician knows your individual history and can
determine the tests that are needed to properly diagnose and treat you.
Medicare does not know you or your needs, but is simply acting as an
insurance company in determining the services it will cover as "medically
necessary."
In some cases, Medicare may deny payment for a test that was previously
covered. For example:
- Although this is the same test, the physician is ordering the test
for a different reason, or
- This is the same test and same diagnosis; however, Medicare has
changed the rules since your last visit and will no longer pay for
this test with this diagnosis.
Even though the Hospital expects payment to be denied, the Hospital
is required to bill Medicare for the service. If Medicare pays for
the
test, you will only be responsible to pay for any deductible or co-payments.
If Medicare denies the claim, you will be responsible to pay the bill.
You have the right to appeal Medicare's decision to deny payment if
you feel that the denial is wrong. If you have supplemental insurance,
you should contact the insurance company directly to see if the test
is covered since each benefit plan is different. Please call one of
our customer service representatives at (909) 980-9511 to answer any
questions you may have about our billing and payment policies.
