Pre-Pay Maternity Package

Pre-Pay Maternity Package

The Birthplace at St. Mary s Regional Medical Center Using the single room maternity concept, The Birthplace at St. Mary s Regional Medical Center features spacious homelike suites where labor, delivery, recovery, postpartum, baby care and family bonding take place. Our nurses represent a wealth of mother/baby experience and have been specially trained to care for both mother and baby through labor, delivery and postpartum care. Highly regarded physicians in the areas of pediatrics, obstetrics/gynecology, family practice and anesthesiology are on staff at St. Mary s Regional Medical Center.* * With limited exceptions, physicians are not employees or agents of St. Mary s Regional Medical Center. The Pre-Pay Package The St. Mary s Regional Medical Center Pre-Pay Maternity Package is designed to assist our uninsured patients by significantly reducing the cost of hospital services for you and your baby without sacrificing the quality of care you ve come to expect. St. Mary s Regional Medical Center is able to offer this lowercost alternative because payment is completed before your admission. That means the hospital can save expenses in billing and record keeping, and this savings is passed on to you. The pre-pay package is not available for patients with insurance coverage. These plans cover all hospital charges incurred at the time of birth for you and your baby. Professional fees between you and your physicians will be billed separately. Hospital epidural services also will be billed separately. The package does not cover treatment of extreme medical conditions, conditions unrelated to pregnancy or services received prior to being admitted for delivery. Prices in this brochure are based on normal, uncomplicated cases for services provided at the time of delivery. To receive information regarding prenatal education programs, call the SMRMC Birthplace Education Line at 580-249-3437. If you are expecting twins or triplets, you can still use the pre-pay package program, with an additional cost of $456 per day each for the second and third child. (ICU or special care nursery services are not included in the package price.)

Program Registration The Unexpected Complete the attached application form and mail it to St. Mary s Regional Medical Center Registration. It is best to enroll in the program early in the second trimester in order to complete all arrangements well before your expected delivery date. Payment can be made in full at the time you sign up for your plan or over a period of monthly installments. If you haven t completed payment at the time of your admission, the package price will be eliminated and the cost will switch to actual hospital charges. St. Mary s Regional Medical Center will be happy to work out a monthly payment schedule for your convenience based on the particular plan selected. If you are planning on a normal, vaginal delivery and find you need a Cesarean delivery, the package price for a Cesarean delivery can apply. The amount you have paid in advance will be applied toward our total cost. You must pay the difference between the normal plan and the C-section plan before discharge. If you choose to stay longer than the plan allows, you will be charged $504 per day for the additional stay. Payment for the difference is required at the time of discharge. St. Mary s Regional Medical Center s package prices will cover normal charges up to three times greater than the selected package price. Charges greater than three times the package price will be billed to you. Package prices through St. Mary s Regional Medical Center are significantly lower than charges at comparable facilities across the country. For example, our package prices are: Plan 1 (normal vaginal delivery) = $3,250; Plan 2 (scheduled Cesarean) = $5,675. Questions? For more information on the pre-pay plans at St. Mary s Regional Medical Center, call 580-249-5803.

Package Options St. Mary s Regional Medical Center provides two pre-pay programs designed to allow you to plan for the cost of having your baby. I am applying for the following plan: q Plan 1 q Plan 2 Plan 1 Normal vaginal delivery Up to two days stay for mother and baby from time of delivery* $3,250 Plan 2 Scheduled Cesarean Up to three days stay for mother and baby from time of delivery* $5,675 *Additional days will be charged at $504 per day. There is no discount in price because of early release. Name: Address: City/State/Zip: Phone: Patient Signature: Expected date of delivery: Please check one: q Prior to admission, I will make periodic payments until my plan is paid in full. q By the time of admission, I will pay my plan in full. Your hospital preadmission form as well as your plan contract should be completed and returned to the St. Mary s Regional Medical Center Admitting Department before or at the time of this application. Admitting Department St. Mary s Regional Medical Center 305 S. 5th Street, Enid, OK 73701 For more information, call 580-249-3054 Effective date: January 1, 2013

305 S. 5th Enid, OK 73701 580-233-6100 www.stmarysregional.com Physicians are independent practitioners who, with limited exceptions, are not employees or agents of St. Mary s Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. 130521