El Campo Memorial Hospital and Mid Coast Medical Clinic

1. El Campo Memorial Hospital and Mid Coast Medical Clinic Medical Discount Card Sign Up Today For Your Discount Card! It’s Free! New!

2. How does the Medical Discount Card work? • Simply present your card to the reception desk, or admissions desk at the time of your medical service. Procedures must be paid for at the time of service to receive your 30% off discount. • There will be no discount on services billed.

3. How to use the card? 1. Make an appointment or go to the Walk-In Clinic. 2. See the Doctor. 3. Present your Medical Discount Card. 4. Pay your entire bill and receive the discount.

4. Who can use the Medical Discount Card? • The Medical Discount Card is for all individuals who do not have any health insurance. • People with Medicaid and Medicare are not eligible. • People with insurance co-pays, deductibles and co-insurance are not eligible.

5. Are there any restrictions? • Patients must pay their medical bill at the time of service to receive the 30% discount. • Services which are billed are not eligible for the discount. • Discount may not be eligible on all / every service. (see booklet for complete list of eligible services at www.ecmh.org)

6. How do I get a card? • Simply fill out the short form and a card will be provided to you at that time. • There is no fee for the card. It is free! • One card per family will be issued. • All members of one family can use the same card. • New Cards and replacement cards are available at the Mid Coast Clinic reception desk, ER desk, front hospital reception desk or call Donna Mikeska at 979-578-5261 for an appointment to get a card.

7. What about professional fees? • Professional fees such as Pathologist, Radiologist, Anesthesiologist, Cardiologist and Surgeon fees are not included in this discount. • All patients are responsible for these fees, bills for these services usually arrive some time after a specific procedure has been completed. • Professional fees are charged separately for interpretation and other aspects of professional management and care and are not a part of the hospital or clinic billing process. • These fees go directly to each independent professional (not an employee of ECMH or MCMC) and are the responsibility of the patient.

8. Where can I see a list of all procedures eligible for a discount? • Check the website at www.ecmh.org • Go to: Medical Discount Program – • Click: Price List For Medical Discount Card • A complete updated list of discounted services is available on that list. • Patients can check ahead of time so they know how much money a procedure will cost. • Patients can be more financially prepared if they check on prices ahead of time. • Printed copies are also available at the reception desks at the clinic and hospital

9. What if I still cannot afford medical treatment? Several financial lending institutions are able that may be able to assist you. • Commercial State Bank, 401 N Mechanic St El Campo TX 77437, 979-543-6441 866-889-4653 • Compass Bank, 1406 N Mechanic St El Campo TX 77437, 979-543-13301st • First Convenience Bank, 3413 W Loop St El Campo TX 77437, 979-578-0135 • First State Bank El Campo Branch, 1808 W Loop St El Campo TX 77437, 979-543-2274 • Newfirst National Bank (First National Bank), 202 E Jackson St El Campo TX 77437, 979-543-3349 979-543-5980 • Prosperity Bank, 1301 N Mechanic St El Campo TX 77437, 979-543-2200 979-543-8461 979-543-6672 • Washington Mutual 800-788-7000 800-374-4646 • TEXAS GULF FEDERAL CREDIT UNION 979-578-9000, 1313 W Loop St, El Campo, TX 77437

10. Additional sources of lending: • Action Finance, 310 E Jackson St El Campo TX 77437, 979-541-5800 • Consolidated Finance, Inc., 1218 N Mechanic St El Campo TX 77437, 979-543-6490 • Noble Finance, 117 E Jackson St El Campo TX 77437, 979-543-0010 • The Loan Store El Campo, 215 W Jackson St El Campo TX 77437, 979-543-2500 • Mr Money Pawn, 213 N Mechanic St El Campo TX 77437, 979-543-7296

11. For additional information on billing services, statements, collections: • Contact the Business Office at El Campo Memorial Hospital at 979-578-5142. • Business Office at Mid Coast Medical Clinic at 979-543-5510 (ask for billing department)

12. Get the Medical Discount Card today for your entire family! It’s Free…..

13. Start getting discounted medical treatment today! • It’s Free….

14. Go to www.ecmh.org • For a complete price list of all medical discounts available with the Medical Discount Card! Once again, that is www.ecmh.org

15. The Medical Discount Card • A service program by El Campo Memorial Hospital and Mid Coast Medical Clinic to enable uninsured patients more affordable medical care. • Note: This program is not a contract for medical services or an insurance agreement. There is no charge for this program. This program does not guarantee that medical services will be preformed on a cash payment basis. This program and pricing are subject to change without notice.

16. The Medical Discount Card • Any discrepancy in pricing between the discount card and the pricing manual, the pricing manual has priority. • Each member must understand that prices and program are subject to change without notice.

17. El Campo Memorial Hospital 303 Sandy Corner Road El Campo, Texas 77437 979-543-6251 www.ecmh.org Mid Coast Medical Clinic 305 Sandy Corner Road, El Campo 979-543-5510