Patient Information
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Medical Forms - Records Release, Living Will, & DPOA
Patient Rights
As a patient at Hillsboro Community Hospital you have the right to:
- Suitable treatment and services regardless of your age, gender, national origin, culture, disability, economic status, educational background of the source or payment for your care.
- Considerable and respectful care from qualified personnel.
- The name of the physician who is responsible for your care and information about your condition.
- Information necessary to allow you to actively participate in decisions regarding your medical care.
- Request a change in physicians or transfer to another health facility for religious or other reasons.
- Information contained in your medical record within the limits of the law.
- Request a specialist or an option from another physician at your own expense.
- Confidentiality pertaining to your diagnosis, care and method of payment.
- Be informed about the hospital charges for services and available payment methods.
- Communicate with people outside the hospital by having personal visits and verbal or written communication.
- Information about medical procedures or treatments that require your consent, including explanation of risks, probable success al alternative treatments.
- Expectation of reasonable safety while receiving services at the hospital.
- Be free of restraints, except as ordered by the physician.
- To refuse treatment. You will be informed of medical consequences for refusing treatment.
- Care that promotes your physical, emotional and spiritual comfort and dignity.
- A grievance process.
It is your responsibility to:
- Provide accurate and complete information about matters relating to your health.
- Follow your treatment plan.
- Provide information need to file your insurance claims and work with the hospital to make payment arrangements.
- Follow hospital rules and regulations, including the No Smoking policy.
- Be considerate of the rights of other patients, staff and physicians.
- Be responsible for your actions if you refuse treatment or do not follow the practitioner's instructions.
- Provide the hospital with a copy of your written advance directives, if you have one.
- Make complaints known so that concerns can be addressed.
Patient Registration Information
Business Office Hours:
8:00 a.m. - 5:00 p.m. Monday - Friday
Closed Weekends and Holidays
Phone: 620-947-1440
Admissions Process:
For non-emergency situations and outpatient visits, please report to the admissions desk in the business office. You will be asked the following:
- Basic information, such as Name, Address, Date of Birth, Social Security Number, Emergency contacts, place of employment, etc.
- If the service is related to an accident or injury.
- For insurance cards or records.
- If the service is related to an auto accident you will need YOUR auto insurance information.
- If the service is related to an accident on someone's property, you will need the insurance from THE HOMEOWNER OR BUSINESS where the accident occurred.
- Medicare patients will be asked to complete a Medicare questionnaire to determine if another insurance should be billed.
- You are encouraged to bring essential personal items such as:
- a comb
- a hair brush
- deodorant
- shaving articles
- toothbrush and toothpaste
- shampoo
- lotion
- soap
- sleeping apparel
- slippers
- a robe
We will be glad to furnish personal items if you choose not to bring them. Medicare and most insurances will not pay for them, you will be responsible for the cost of these items.
- A list of the medications you are currently taking at home.
- Medical insurance cards or insurance coverage information.
- If you have a Living Will or a Durable Power of Attorney for Health Care Decisions bring a copy if you are not sure that it is already on file at the hospital.
- Please, leave your valuables at home
We ask that you do not keep more than $5.00 cash in your room. We also ask, for safekeeping, that you send valuables home if at all possible.
Hospital personnel are required to respect your privacy and treat all information in strict confidence. Information in your patient record is available to the staff providing your care on a need to know basis only. We ask for your assistance in respecting the privacy of other patients as well. Please do not ask the staff about other patients, as staff is required to respect their privacy as well as yours.
Billing Questions
The business office at Hillsboro Community Hospital strives to serve you in an effective and efficient manner. We know that financial concerns can add to the stress of any medical need. Please call the business office at 620-947-1440 if you have any questions about your bill. You may also contact us by email at Billing Questions.
Your insurance company will pay the portion of your medical bill covered by your plan. You are responsible for any deductibles or co-payments. You will be sent a summary statement indicating your amount due after your insurance has paid. Payment in full is requested. If you are unable to pay the full amount due, please contact the business office at 620-947-1440 to set up a payment plan.
If you do not have health insurance, please contact the business office prior to your dismissal to discuss payment options or financial assistance programs that may be available to you.