≡ Compliance at Jackson General Hospital
Compliance at Jackson General Hospital
Frequently Asked Questions:
- What is the Compliance Program?
- Why does Jackson General Hospital need a Compliance Program?
- Who is responsible for compliance at Jackson General Hospital?
- What are compliance issues?
What is the Compliance Program?
The Compliance Program is a hospital-wide program designed to promote and ensure that the hospital’s commitment to integrity and the highest ethical standards are completed.
Why does Jackson General Hospital need a Compliance Program?
As laws and regulations continually change, the Program is designed to proactively meet those needs by providing access to information and resources to promote awareness and prevent potential legal issues. The specific purpose of the Program is to reduce any risk, therefore maintaining integrity and the positive reputation of Jackson General Hospital.
Who is responsible for compliance at Jackson General Hospital?
The Chief Compliance Officer coordinates and oversees the Compliance Program for the hospital. It is important to emphasize that every member of the Jackson General Hospital Staff, including volunteers and students, have an important role to play in the Program. The Program encourages every individual to take part in compliance from knowing and following various laws, regulations and policies of the hospital to reporting any incident you are aware of that could be considered non-compliance. You may contact the Compliance Officer by telephone at 304-373-1508, hotline at 304 572 5094 or email at firstname.lastname@example.org.
What are compliance issues?
Compliance issues relate to situations, activities and transactions that could violate federal and state laws/regulations, in addition to Jackson General Hospital’s policies. Examples include violations of regulations associated with fraudulent financial activities, conflict of interest, sexual harassment, discrimination, information security, health/safety environment, fraud, financial reporting and controls, etc. This is not meant to be a complete list but rather examples of compliance issues.
Principle of Ethical Conduct (Compliance Plan)
The Compliance Plan discusses Jackson General’s shared values and beliefs. The Plan promotes a commitment to integrity throughout our hospital. It is the foundation of the Compliance Program and represents what others are to expect.
≡ HIPPA Privacy and Security
Jackson General Hospital is committed to protecting our patients' privacy and rights. HIPAA, the Health Insurance Portability and Accountability Act of 1996, is a law designed to help ensure the portability of health insurance coverage, reduce health care fraud and abuse, enforce standards of health information and guarantee the security and privacy of health information.
Our goal at Jackson General Hospital is to meet and exceed the demands of HIPAA, and to protect our patients’ privacy and confidentiality without exception.
We encourage our patients and their families to familiarize themselves with Jackson General Hospital’s Notice of Privacy Practices.
≡ Kudos/Concerns related to your experience at Jackson General
If you would like to share concerns/kudos regarding an experience or issue regarding safety or quality of care at Jackson General or one of our clinics (MHHC or Jackson Clinic at Walmart), please contact our CCO/Patient Safety Officer.
These issues may also be reported to the Joint Commission. No disciplinary action will be taken against staff reporting quality/compliance concerns to the CCO, Joint Commission, or OHFLAC.
Immediate Supervisor — If not practical or possible, contact:
If not practical or possible, contact:
U.S. Department of Health and Human Services
Office of Health Facility Licensure and Certification
≡ Medical Records
Health Information Management Department is open Monday – Friday, 9:00 a.m. – 4:00 p.m. for release of medical records.
HIM can usually respond to requests for medical records within 30 days. The average turnaround time is 2-3 weeks.
Records cannot be provided immediately due to the time it takes to gather the requested information and process the request.
Medical Records may be mailed to you, or you may call ahead and make an appointment to pick them up. Medical Records may also be faxed to your physicians.
How to request records:
- Your provider can request records, free of charge (provider is someone providing professional medical care).
- You can call for the authorization form to receive your records by mail. the form will be sent to your address with a pre-addressed, stamped envelope. Complete the form and mail back to the medical records department.
- Make an appointment, or walk in.
- Stay informed, Stay in Touch, Stay in Good Health by registering for JGH My Health Online on our JGH homepage.
Call 304-373-1616 for more information.
≡ Privacy Practices
≡ Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS)
The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care. HCAHPS (pronounced "H-caps"), also known as the CAHPS Hospital Survey, is a survey instrument and data collection methodology for measuring patients' perceptions of their hospital experience. While many hospitals have collected information on patient satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and publicly reporting information about patient experience of care that allowed valid comparisons to be made across hospitals locally, regionally and nationally.
Three broad goals have shaped HCAHPS. First, the survey is designed to produce data about patients' perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers. Second, public reporting of the survey results creates new incentives for hospitals to improve quality of care. Third, public reporting serves to enhance accountability in health care by increasing transparency of the quality of hospital care provided in return for the public investment. With these goals in mind, the Centers for Medicare & Medicaid Services (CMS) and the HCAHPS Project Team have taken substantial steps to assure that the survey is credible, useful, and practical.
≡ Patient Financial Services
Financial Counselors are available to assist you with questions regarding insurance, public assistance programs, Uncompensated Free Care program, and making payment arrangements.
To reach a counselor (Monday – Friday):
- 8:00 a.m. – 4:30 p.m., please call 304-373-1510 or 1511 from a hospital phone
- After 4:30 p.m., please call 304-373-1510 or 1511 from a hospital phone and leave a message
- Case Management Coordinator can be reached at 304-373-1562 from a hospital phone
Your Case Manager is a registered nurse (RN) who will work with you to help decide what the most appropriate discharge plan is for you and will coordinate these plans. You can contact your Case Manager by dialing ext. 1504 or 1505 (304-373-1504 or1505). The message you leave will be conveyed to your Case Manager who will respond to your questions.
Check with Your Insurance Company
Prior to scheduling your hospital or clinic visit, you should check with your health insurance plan to see if you have access to healthcare services at Morad-Hughes Health Center and learn the specifics of your coverage. The customer service representative with your insurance company is the best person to inform you of the level of coverage you will have as a patient at Jackson General Hospital. Otherwise, you may be responsible for all or a large portion of your bill. You can also find out what, if any, copayments, coinsurances and deductibles will be your responsibility.
The Billing Process
We appreciate that you chose Jackson General Hospital. We understand that billing and making payment arrangements can be confusing and complicated. Our Patient Financial Staff is here to assist you with information about your bill(s). It is important for you to understand that your hospital bill does not include charges for physicians' care. You may receive separate bills -- one from JGH, one from Premier Imaging for Radiologist services, and other physicians that may have consulted.
Your hospital bill will include charges for:
- Room Pricing
- Emergency services
- Laboratory services
- Radiology (x-rays)
- Medical supplies
- Other services
If you have questions about your hospital bill, you may check with the Billing Representative on the second floor, or call the following (patients last name):
Patients who have not completed their insurance information while at the hospital will be responsible for paying their bill within 30 days after receiving their first statement. As a patient, you may request itemized billing and will receive monthly statements of your account with the hospital.
As a courtesy, the hospital will file a claim with your insurance company, based on the insurance information you provide. However, payment for services is your responsibility, and we encourage you to contact your insurance company for the status of payment on your behalf.
Our Financial Counselors and Case Management staff are familiar with many programs that provide financial assistance and will help you apply for assistance. To be considered for any assistance, you will have to complete a charity application.
Important information about paying for hospital care
In emergencies, treatment will not be delayed because of financial or insurance issues.
We will bill your health insurance if you are insured. Financial Counselors are available to speak with you regarding payment arrangements if you do not have health insurance coverage. In addition, JGH offers financial assistance and our staff will assist you in completing the charity application.
Financial Requirements for Admissions
Jackson General Hospital and its medical staff will provide any person who comes to the hospital and requests examination of or treatment for an emergency medical condition with an appropriate medical screening examination and, if the person has an emergency medical condition, will treat the person, within JGH’s capabilities. JGH will not delay the medical screening or stabilization of the person to inquire about insurance or ability to pay or to seek prior authorization. JGH will admit any person with an emergency medical condition, without regard to the person’s ability to pay.
Hospital Discount Policy
Jackson General Hospital provides prompt pay discounts. For more information please contact our Financial Counselors by calling:
Charity Care Adjustment
JGH is a not-for-profit hospital committed to providing medically necessary, high-quality healthcare services regardless of our patients' ability to pay. The hospital acknowledges that there are patients who do not have the ability to pay for medically necessary healthcare services and those individuals may be provided charity care as established by JGH’s policy. Full charity assistance will be provided to those patients where the household income (defined as income for all individuals existing in the same dwelling) is at or double the federal poverty guidelines as published annually by the Federal Register, and notified by the West Virginia Hospital Association bulletin of Federal Poverty Guidelines and where there are not substantial assets. Eligibility determination is made based on completion of the following requirements.
Bankrupt patients may be considered for Charity Care upon receipt of bankruptcy notice. A Proof of Claim must be filed, except when the bankruptcy notice indicates that there are no assets from which any dividend can be paid.
Patients who meet West Virginia Department of Welfare income and resource guidelines, but who are categorically eligible (spin-down) for Medicaid may be considered medically needy and eligible for Charity Care, provided all appropriate applications were completed.
Charity Care will be denied to patients who refuse to take reasonable actions necessary to obtain medical assistance available through outside health and welfare agencies when referred by the Financial Counselors.
Patients will be required to assign or pay, to the Hospital, all insurance payments or liability settlements designated as remuneration for medical expenses. Payments received on an account with a Charity Care Adjustment will be applied to the account and the adjustment reversed up to the amount of the Charity Care Adjustment.
In the event that a Charity Care Adjustment application is not received, the approved applicant shall be required to pay an amount equal to the expense incurred in initiating such action.
In compliance with state law, Jackson General Hospital is providing a price list of charges for services offered at Jackson General Hospital. The hospital’s charges are the same for all patients, although a patient’s responsibility may vary, depending on a patient’s insurance coverage and payment plans negotiated with individual insurance companies.
Uninsured or underinsured patients should contact our Financial Counselors to determine whether they qualify for discounts by calling: (304) 373-1510 or (304) 373-1511.
The link listed below with prices is a per item charge from the hospital charge master and the final bill for services may differ due to unforeseen complications, additional tests or procedures needed at the time of service. Certain procedures will require multiple items from the list to be charged, but the exact items may not be known until the service(s) are performed.
These prices are effective as of 10/01/2018.
If you have any questions or comments, please feel free to contact the Business Office/PFS Director at 304 373-1480.
≡ Patient Services Departments
- Case Management
- Emergency Department
- Health Net
- Infusion Services
- Jackson General Clinic at Wal-Mart
- Morad/Hughes Health Center & Primary Family Care
- Diabetes Management & Education
- Nutrition Services
- Pathology and Laboratory Services
- Physical Therapy
- Pain Interventionist
- Radiology (diagnostic, mammography, ultrasound, CT scan, nuclear medicine)
- Respiratory Therapy
- Surgery (Inpatient, outpatient, recovery room, Anesthesia)
- Surgical Associates
- Orthopedic services
- Rehabilitation "Swing" Bed Services
≡ Meals & Room Service
The Nutrition Service Staff works closely with a Registered Dietitian to offer attractive, nutritionally adequate and satisfying menus. The Nutrition Service Department provides meals and snacks for the patients, the public is welcome to eat in our cafeteria, which has a weekly menu posted and is open daily.
The staff takes great care to prepare and expedite the appropriate physician-ordered diet for our patients.
Jamie Pratt, Med, RD, LD
Melanie Hall, CDM, CFPP
Nutrition Service Director
Located at the volunteer desks in the front lobby & back ER/Outpatient Waiting Area
Long Distance Calling (for patient phones)
Dial 9 + 0 + Area Code + Number
Patient will be presented with billing options
Long Distance Billing Options
Collect — dial 11
Calling Card — can use any card
Billing To Another Number — someone must be at the “Bill To” number to accept / approve the charges. “Bill To” number also must be allowed to accept collect call charges (no block on line).
To reach an extension inside the hospital, dial the last 4 digits of the phone number. All incoming calls are directly connected to your room. For the health and well being of our patients, incoming calls can not be received before 8am and after 10pm.
≡ Visiting Hours
Our visiting hours are designed to accommodate both your needs and the needs of your family and friends.
Visiting hours are between 11:00 a.m. and 8:00 p.m.
Whenever possible, we attempt to be flexible and accommodate your visitor at a time that is convenient for the both of you. Please check with your nurse with any specific questions.
Due to the nature of certain medical conditions, the following areas have specific visiting hours:
All visitors 11:00 a.m. – 8:00 p.m.
Weekends/Holidays 1:00 p.m. – 3:00 p.m. and 6:00 p.m. – 8:00 p.m.
Critical Care Unit:
Visiting times depend on the patient’s condition.
Our Cafeteria welcomes visitors at these hours:
Breakfast 7:30 a.m – 9:00 a.m.
Lunch 11:00 a.m. – 1:30 p.m.
Dinner 4:30 p.m. – 6:00 p.m.
≡ Gift Shop
If you or your visitors wish to buy unique gifts, games, cards, candy, jewelry, and much more, please visit our Gift Shop.
The Jackson General Gift Shop, located in the main lobby, is open at the following times:
Monday – Friday 9:00 a.m. – 6:00 p.m.
For any questions, you can contact the Gift Shop from your bedside phone at ext. 1487 or by calling 304-373-1487.
Newspapers are available in vending machines outside of the Main Hospital Entrance.
≡ Public Restrooms
Public restrooms are located in the following areas:
- First Floor
- Main entrance down the hall past Information Desk
- In the Emergency Department waiting area
≡ Pastoral Care
The hospital’s non-denominational chapel is always available and provides a quiet place for prayer or meditation for patients and family members. It is located on the hospital’s first floor prior to Respiratory Rehabilitation and MHHC. Local priests and ministers frequently visit the hospital. To arrange a visit from one of our community clergy, please ask your nurse for assistance or call extension 1477.
≡ Discharge Information
Your physician will determine when you will be medically ready to be discharged. He or she will alert other members of the health care team that you are ready to go home and the services you will need to have in place before your discharge.
Your nurse will review your discharge instructions and your medications. You will be given a written copy of these instructions to use as a reference at home. Our preferred discharge time is 11 a.m. However, there are times when due to the patient’s condition and/or required treatment that discharge may be at a later time.
An associate or a volunteer may escort you to the front door. There will be a wheelchair available should you require one. Please have your family member or friend drive up to the door of the hospital to pick you up. If there are any financial issues incomplete at the time of discharge, you will be asked to call the financial counselor at ext. 1510 or 1511 before you leave the hospital.
Understanding Health Information Privacy
The HIPAA Privacy Rule provides federal protections for individually identifiable health information held by covered entities and their business associates and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of health information needed for patient care and other important purposes.
The Security Rule specifies a series of administrative, physical, and technical safeguards for covered entities and their business associates to use to assure the confidentiality, integrity, and availability of electronic protected health information.
≡ Guest Wifi
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