Patients & Visitors
Below you will find resources the providers at Ringgold County Hospital and Mount Ayr Medical Clinic in Mount Ayr, Iowa, believe will be helpful to our patients and visitors. Do you need additional information? Call us at (641) 464-3226 – we’re always happy to help.
Quick Links
For Patients:
- What to Bring With You
- Patient Forms
- Patient Portal (view your health records online)
- Hospital Policies
For Visitors:
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What to Bring with You
We want your experience at Ringgold County Hospital and Mount Ayr Medical Clinic to be as streamlined and pleasant as possible, so we ask that you bring the following information with you when requesting treatment:
- Patient’s most current insurance card, Medicare card, or Medicaid recipient eligibility card
- Patient’s date of birth
- Patient’s social security number
- Patient’s current address and phone number
- Name and address of any potentially liable person if the patient was involved in an auto accident or other type of accident
- A means of paying your co-payment or deductible at the time of service, such as cash, check, or credit card
- Drivers license or passport
PATIENT FORMS
For your convenience, some forms may be signed prior to your appointment. Please do not sign forms that require a witness.
- Athletic/Sports Physical Form
- Medical Records Release – please do not sign until in the presence of an RCH or Mount Ayr Medical Clinic registration employee
- Allow us to discuss your care with others – please do not sign until in the presence of an RCH or Mount Ayr Medical Clinic registration employee
- E-Prescribing/Pharmacy Consent Form
- Drive-Thru Flu Shot Consent Form
- Application for Financial Assistance
- HIPAA Notice of Privacy Practices
Keeping an accurate record of your medications is critical for your treatment.
Bring an up-to-date list of all your medications – including prescription and over-the-counter medicines and any dietary supplements – and any allergies you have to each doctor visit or hospital stay.
- If you do not have an up-to-date medication list, bring your medications in the original pharmacy bottles.
- If you are given a new medication by one of our providers, make sure you understand what the medication is, why you are taking it, when you should take it, and any potential side effects to watch for. Your nurse will be happy to give you this information.
Ringgold County Hospital participates in e-prescribing, a service that electronically sends your prescription requests to your pharmacy. However, when your doctor writes you a prescription, make sure you can read it. If you can’t read your doctor’s handwriting, your pharmacist might not be able to, either. When you pick up your medicine from the pharmacy, check that it is what the doctor prescribed. Learn more about safe prescription use.
In most cases, patients are only required to bring a photo ID and insurance card to the hospital upon admission.
In general, it is advised that you pack light for an inpatient (overnight) hospital stay. For example, you may wish to bring a small overnight bag that includes a change of clothing for when you leave the hospital. RCH will provide each patient with a hospital gown. You may wear your own sleepwear instead of a hospital gown in most cases, but we ask all patients to wear a hospital gown for testing, examination, and procedures.
Other items you may need include:
- List of all medications you currently take
- Name and contact information for your emergency contact
- Advance directives, if any
- Bathrobe and slippers, if desired
- Brush or comb
- Toothbrush and toothpaste
- Underwear and socks
- Personal toiletries
- Eyeglasses or contact lenses with case
Please do not bring personal belongings or valuable items to the hospital that are not essential to daily living. This includes photographs, memorabilia, large sums of cash, credit cards, or jewelry. Ringgold County Hospital cannot be responsible for the safekeeping of these items.
Hospital Dining Options
The hospital’s dining room serves meals during the following time periods:
- Breakfast: 7:30 am – 9:30 am
- Lunch: 11:30 am – 1:00 pm
- Dinner/Supper: 4:45 pm – 5:30 pm
Inpatient Suggested Meal Times:
Breakfast: 7:30 a.m.
Lunch: 11:45 a.m.
Supper: 5:00 p.m.
Snack: as requested Family Dining Services
Dining Room Breakfast, Lunch, & Supper:
$5.00 per meal Fountain Machine
$1.50 per cup
*prices may vary accordingly
Breakfast Served: 7:30 a.m.- 9:00 a.m.
Lunch Served: 11:00 a.m.- 1:00 p.m.
Supper Served: 4:00 p.m.- 5:30 p.m.
Most patients come to the hospital with some form of insurance coverage. Regardless of the type of insurance coverage you have, you are ultimately responsible for payment of your medical bills. Although we will bill on your behalf and make all reasonable efforts to obtain payment from your insurance, if your insurance company rejects the claim or delays payment, we will look to you for payment in full. Insurance companies sometimes require additional information before claim processing can be completed. Your prompt response to these requests for information will speed up processing and potentially reduce the amount you owe.
Once insurance has paid on your account, you will receive a statement from us indicating the balance you owe if it was not paid at the time of service. This balance is due and payable by you when you receive your statement. You may pay your account by cash, check, credit card, or by automatic withdrawal from your checking account.
Ringgold County Hospital recognizes that health problems are often unexpected – so, healthcare costs are often unplanned for or may be greater than expected. To find out what financial assistance may be available to you, speak with a Ringgold County Hospital patient accounts representative by calling (641) 464-4459 during the hospital’s regular administrative hours (Monday – Friday, 8 am – 4:30 pm) or send an e-mail to medicalbills@rchmtayr.org.
Should an overpayment on your account occur, we will investigate the nature of the overpayment and make a refund to the appropriate party. If the refund is to go to you, we will apply it to any other account balances you may have outstanding and will then refund to you any remaining balance.
We try to make sure we receive authorization for your services at Ringgold County Hospital, but every insurance company has its own prior authorization requirements. We encourage you to check with your insurance company or your employer to verify this information.
Insurance companies have multiple plan options, which makes it difficult for us to know all that is covered by the plan. Contact your insurance company or your employer with specific questions about what is or is not covered by your insurance plan.
Yes. Your insurance card is needed when you register to ensure we get the correct information to file a claim with your insurance company. Make sure you bring all relevant insurance information, especially if you have more than one insurance plan. If we do not have the correct insurance information, we cannot bill your insurance company on your behalf, and it will become your responsibility to do so.
You may receive more than one bill for the same hospital stay. These bills are usually for services provided by physicians, anesthesiologists, or other professional medical groups. Although Ringgold County Hospital bills for some of these same services, you may receive a separate bill directly from other providers.
Hospital charge data is being provided as part of a federal regulatory policy mandated by the U.S. Department of Health & Human Services and Centers for Medicare & Medicaid Services.
Some important items to note:
- Hospital charge data is not representative of a patient’s expected out-of-pocked costs. Because each patient’s case is different based on specific conditions, the actual amount owed by a patient will depend on that patient’s insurance coverage.
- Hospital charge data is the amount a hospital bills an insurer for a service. In the vast majority of cases, however, hospitals are reimbursed by insurance companies and Medicare/Medicaid at a rate that is considerably less than the amount charged.
- Patients should talk with their insurance provider to understand which costs will be covered, and which costs will be the patient’s responsibility.
Understanding healthcare terminology around price poses significant challenges for patients. If you ask a group of people to define what “price” is, it is likely you will get a variety of answers. Below are definitions to help frame the understanding on this issue.
The dollar amount assigned to specific medical services before negotiating any discounts from payers. The charge is different from the price. Very few patients pay the charge, regardless of their insurance status. Therefore, this data is not meaningful to people.
The definition depends on the cost being referenced:
- To the provider, cost is the expense incurred to provide healthcare to patients.
- To the employer, cost is the expense related to providing health benefits.
- To the insurance plan, cost is the price paid to the provider.
- To the patient, cost is the out-of-pocket fees.
Out-of-pocket refers to the portion of the price for medical services and treatment for which the patient is responsible. This includes co-payments, co-insurance, and deductibles.
Out-of-Pocket Cost Estimates
At Ringgold County Hospital, we support price transparency and believe it is important for you to know what out-of-pocket costs you will incur for services provided at RCH.
We have established three easy ways for you to obtain a good-faith estimate of your costs:
- Call us at (641) 464-4404
or
or
- Complete our online Patient Estimator
By calling or emailing us, we can give you an accurate estimate of your out-of-pocket costs for medical services or procedures at Ringgold County Hospital.
To obtain this estimate, we review:
- The specific service or procedure you will receive
- The physician providing the service
- Your insurance, including what you have already paid toward your deductible
You can also download a spreadsheet of our standard charges to review.
The negotiated and contracted amount to be paid to providers by payers (also called the “allowed amount”). A patient’s out-of-pocket liability for healthcare services is based on this allowed amount. Note that the price for a given service varies by insurance plan, as these are separately negotiated by plan/employer.
Hospital Policies
Patients and their legal representatives generally have a right to their medical records. All you need to do is make a written request and, in some cases, pay a fee.
- Medical Records Release – please do not sign until in the presence of an RCH or Mount Ayr Medical Clinic registration employee
An advance directive is a written statement that documents your healthcare decisions or appoints another person to make decisions on your behalf. Advance directives include living wills and a durable power of attorney for healthcare. Visit the living wills page on the Iowa State Bar Association website for more information.
This Code of Conduct policy outlines responsibilities expected of all who work for Ringgold County Hospital.
Financial assistance is available for Ringgold County Hospital patients.
Organ and tissue donation after your death can play a vital role in improving the quality of life for others. Register with the Iowa Donor Network.
We are dedicated to maintaining the confidentiality and security of your health information. As a patient at Ringgold County Hospital, you can count on us to keep your health private and secure from any unauthorized access. Find out more in our HIPAA Notice of Privacy Practices.
To protect the health of all patients, visitors, and staff, the Ringgold County Hospital campus and its properties are tobacco-free (including parking lots). Medication is available to patients to help curb their craving for tobacco.
When you receive emergency care or are treated by an out-of-network provider at an in-network hospital, you are protected from surprise billing (also sometimes called balance billing). Find out more about your rights and protections against surprise medical billing.
