Osawatomie State Hospital and Adair Acute Care Business Services / Patient Accounts

Letter from the Superintendent

Letter from the SuperintendentAt Osawatomie State Hospital (OSH) and Adair Acute Care (AAC), we believe no one should be turned away from the treatment they need because of their ability to pay. We also believe that your ability to pay should not dictate the quality of care you receive. Every day, we are working to ensure quality services in a safe environment, delivered by staff committed to your recovery.

The Centers for Medicare & Medicaid (CMS) mandates in the 2019 Medicare Inpatient Prospective Payment System Final Rule, for hospitals to make available a list of their standard charges in machine readable format, effective January 1, 2019. OSH and AAC comply with this regulation. Additionally, we believe it is important for you to understand the cost of your care and how we calculate your bill.

The charge masters we have posted to this webpage include several services available, however this cannot be the only data used by patients to help determine the cost of their stay. To assist patients, we’ve also included our frequently asked questions, our assessment rate calculator, a Medicare Rate Calculator (should it apply), as well a link to the poverty guidelines we use.

Please take a moment to review the information listed below.  If you have any questions, please do not hesitate to contact our Patient Accounts department.

Thank you for trusting us with your care,

Superintendent Ashley Byram

Forms / Guidelines

View the U.S. Department of Health & Human Services website for up-to-date information about federal poverty guidelines. The 2020 poverty guidelines are in effect as of January 15, 2020:

https://aspe.hhs.gov/poverty-guidelines
FileTypeSizeUploaded onDownload
Financial Assistance Application FormPDF338.83 KB14 Apr, 2021 Download
Osawatomie State Hospital Ability to Pay Information FormPDF189.46 KB14 Apr, 2021 Download
Adair Acute Care Ability to Pay Information FormPDF180.99 KB14 Apr, 2021 Download

Worksheets

FileTypeSizeUploaded onDownload
Medicare Rate CalculatorXLSX15.06 KB16 May, 2023 Download
Assessment Rate Calculation WorksheetXLSX12.98 KB14 Apr, 2021 Download

Charge Masters

FileTypeSizeUploaded onDownload
Adair Acute Care ChargesXLSX235.33 KB16 May, 2023 Download
Osawatomie State Hospital ChargesXLSX235.33 KB16 May, 2023 Download

Frequently Asked Billing Questions

  • I was involuntarily committed, am I still required to pay for my stay?

  • What is included in the cost of my stay?

  • How do you determine what I owe for my stay?

  • Am I charged per day or per month?

  • What if I have insurance, Medicare or Medicaid?

  • What if I am not able to pay my bill because my financial situation has dramatically changed since the last time my income was assessed?

  • Can I make payments for my stay and is there a minimum payment due?

  • If I do not fulfill my assessed obligation, will my information be sent to a collection company?

  • Is there anyone I can speak to if I have additional questions?

Information to Bring at Admission

At the time of a patient’s admission to the hospital, it is helpful, but not required, to have the following information available:

  • Insurance company name and address
  • Insurance policy and group numbers
  • Medicare number
  • Medicaid number
  • Proof of Income (previous years’ income tax return)