Patient Resources

Chapel

The interfaith Murray Heilig Chapel is available for meditation, prayer, and reflection at all times. It is located on the M-level at UConn John Dempsey Hospital.

Chaplaincy Program

The Chaplains offer spiritual and emotional support, prayer, and pastoral counseling for patients and their families. They are available to people of all faiths, as well as to those not connected to an organized religion. Patients may request a visit by a minister, rabbi or priest for sacraments or other ministry. Roman Catholic Eucharistic Ministers administer Holy Communion on Sundays and weekdays by request.

Gratuities

We must graciously decline gratuities of any kind. Contributions to the UConn John Dempsey Hospital or UConn Health may be made by contacting the Foundation at 860-679-1122.

Interpreter Services

UConn Health and its affiliates, including UConn John Dempsey Hospital and UConn Medical Group, provide equal access to all persons, including those who have Limited English Proficiency (LEP), those who are deaf, hard of hearing, visually impaired or have special communication needs.

To make sure everyone is understood, we provide sign language and oral interpretation, video phones, assisted listening devices, and other auxiliary aids; plus translation of written materials. All services are FREE of charge to patients and companions who are deaf, LEP, hard of hearing or have speech disabilities. Interpreters are available 24 hours a day, 7 days a week.

You have the right to an interpreter. Please tell our staff if you require help, or call 860-679-2626 and we will arrange it for you.

UConn Health does not discriminate on the basis of any protected class including disability, ancestry or national origin. If you would like to file a complaint, please contact the UConn Health ADA Coordinator through the Office of Institutional Equity, 860-679-3563 or email equity@uchc.edu.

Los servicios de asistencia de idiomas.

UConn Health y sus afiliadas, incluyendo UConn John Dempsey Hospital y UConn Medical Group, brindan acceso equitativo a todas las personas, incluyendo a aquellas que tienen dominio limitado de inglés (LEP, por sus siglas en inglés), aquellas con sordera, dificultad para escuchar, discapacidad visual o tienen necesidades especiales de comunicación.

Para asegurarnos de que todos sean entendidos, brindamos el servicio de lenguaje de señas e interpretación oral, teléfonos con video, dispositivos de audición asistida y otros dispositivos auxiliares de ayuda; además de traducción de material escrito. Todos los servicios son GRATUITOS para los pacientes y acompañantes que tengan discapacidad auditiva, dominio limitado del inglés, dificultad auditiva o tengan discapacidad del habla. Intérpretes disponibles las 24 horas al día, los 7 días de la semana.

Usted tiene derecho a un intérprete. Favor de comunicarse con nuestro personal en caso de necesitar ayuda, o llame al 860-679-2626 y nosotros se lo tramitaremos.

UConn Health no discrimina sobre la base de alguna clase protegida incluyendo discapacidad, descendencia u origen nacional. Si usted desea presentar una queja, sírvase llamar al Coordinador ADA (Ley de Ciudadanos Americanos con Discapacidades) de UConn Health a través de La Oficina de Equidad Institucional al 860-679-3563 o envíe un correo electrónico a equity@uchc.edu.

Mail and Flowers

Volunteers deliver mail and flowers daily. If mail is received after you have been discharged, it will be forwarded to your home. If you have mail to be sent, you can call the Hospital Information Desk and request a volunteer to pick it up. Mailboxes are located directly outside the Main Building and Academic entrances to UConn Health.

Nutrition Services

We are pleased to offer At Your Request-Room Service Dining for our patients. This innovative dining program allows you to select meals from a wide variety of foods designed to enhance your experience as though you were eating at your favorite restaurant. We offer weekly food specials and guest trays for visiting guests and family members. Vouchers are purchased in the cafeteria. The Food & Nutrition department will make every effort to accommodate your religious, ethnic or personal dietary needs.

Patient Education

UConn Health providers have chosen the Elsevier patient education content database as a resource for your reference. It’s accessible online at any time, and information specific to you will be available through the MyChart patient portal, the electronic medical record system at UConn Health. The information you find in Elsevier is available in multiple languages and is regularly reviewed and updated based on the most current evidence-based findings in renowned medical journals throughout the world.

Patient Relations Department

We would like to resolve any concern you might have as soon as possible. Please first discuss it with the staff on the unit; you may also request to speak to the nurse in charge, assistant manager or manager.

The Patient Relations Department helps patients seek solutions to problems, concerns, and unmet needs. A patient representative will assist you whenever possible, to interpret the hospital's philosophy, policies, procedures, and services for you, as well as your family and visitors; and serve as your resource for information regarding patient rights and responsibilities. The patient representative can be reached weekdays between 8 a.m. and 4:30 p.m. by calling extension 3176. Should your need arise after 4:30 p.m. or on a weekend or holiday, your nurse will contact the appropriate persons for you.

Complaint: any concern received (verbally or in writing) that can be resolved by the staff present

Grievance: any concern received (verbally or in writing) that cannot be resolved by the staff present

If you would like to provide feedback or have a complaint or grievance that is not urgent, a letter or note is welcomed.

If you file a grievance, please be assured that it is taken seriously. The Department of Patient Relations investigates all grievances received from patients or an acceptable patient designee. Upon receipt of a grievance, a letter is sent to the author acknowledging receipt and that a review is underway. The appropriate managers and staff will be involved in the review. Upon completion of the review, a letter is sent to the author detailing the results of the review.

You may also choose to contact one of the following agencies:

Department of Public Health
410 Capitol Avenue
Hartford, CT 06134
Phone: 860-509-7400
TDD: 860-509-7191

KEPRO
5201 Kennedy Boulevard, Suite 900
Tampa, Florida 33609
Phone: 1-844-455-8708
TTY: 855-843-4776

The Joint Commission
Office of Quality Monitoring
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Phone: 1-800-994-6610
Email: complaint@jointcommission.org
Website: jointcommission.org

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, DC 20201
Phone: 1-800-368-1019
TDD: 800-537-7697

Social Work Services

Many patients may experience a normal emotional reaction to being in a hospital environment. For other patients, illness and hospitalization may create or worsen such serious problems as family or marital conflicts, financial needs, substance abuse disorders, need for placement other than home, parenting difficulties, psychological reactions, or work-related issues. Our licensed, master’s prepared social workers are skilled in helping you find solutions to any of these problems, which may interfere with your recovery or your lifestyle.

Special Accommodations

UConn Health is committed to ensuring the full participation of persons with disabilities in programs and activities by providing necessary auxiliary aids and services free of charge.

Wireless Technology

UConn Health provides free guest Wi-Fi service via our wireless network. “UCHC-GUEST” will allow patients and visitors to access the Internet with their own electronic device. If you require assistance connecting, please ask for the one-page instruction sheet to help you log on.

Post-Acute Care Network

When you’re ready to go home, UConn Health is committed to providing a well-coordinated plan for a safe transition. Your health care provider may recommend a brief recovery period in a short-term rehab facility or follow-up nursing care in your own home. Patients are free to choose any post-acute care provider. UConn Health recognizes that sometimes choosing a facility can be overwhelming. In response, we have carefully vetted and partnered with several skilled nursing facilities and home health care agencies to form a preferred post-acute network.

The facilities and agencies listed have committed to keeping your primary care provider informed of progress and any changes related to your health to facilitate a smooth return to your home. In many of the facilities, members of the UConn Health medical staff visit patients during their stay to continue to provide exceptional care.

Talk to your provider for more information and a full list of skilled nursing, home health, and hospice options.

Skilled Nursing Facilities

Avon Health Center

Bel-Air Manor Nursing & Rehabilitation Center

Hughes Health & Rehabilitation

McLean Health Center

Touchpoints at Farmington

The Pines at Bristol Center for Health & Rehabilitation

West Hartford Health & Rehabilitation Center

Home Health and Hospice Agencies

Constellation Health Services

Farmington Valley Visiting Nurse Association

McLean Home Care & Hospice

• General Information
• How to Request Medical/Dental Records
• How to Submit Your Request
• How to Request X-Ray Images
• How to Request Dental X-Ray Images
• Is There a Charge Associated with Requesting Copies?
• How to Request Copies of Billing Records
• How to Request Pathology Slides

 

General Information

The Health Information Management Department maintains records of your treatment for all your care. The records are the property of UConn Health; however, patients have the right to view and receive copies of their medical/dental records. Your request to view or receive a copy of your medical/dental records must be made in writing.

All copies of medical/dental records are released from the Health Information Management Department/Release of Information Office. You may also speak to your provider at the time of your appointment about obtaining selected information from your records that might be necessary for urgent patient care needs.

You may also view or print select portions of your UConn Health medical records using the MyChart patient portal. Log on to MyChart for more information on accessing your information.

Other forms of health information such as X-ray images (including dental X-ray images) and lab slides not considered part of your medical records must be requested directly from the appropriate departments (e.g., Radiology Department, Laboratory Medicine Department, or Dental Care Center). Please see below.

Also, your medical records do not contain billing information. Contact the Clinical Business Services Department to obtain copies of your billing records.

UConn Health does not provide copies of birth/death certificates. Please contact your respective town or city or visit their website to request a copy.

How to Request Medical/Dental Records

You may request your own medical/dental records by completing a Patient Request to Access Medical Records form.

For release of information requests made by a third party that require patient authorization, use the Authorization to Obtain and/or Disclose Health Information form.

To help us expedite your request for access to your own information, take note of the following when completing the Patient Request to Access Medical Records Form:

• Please print clearly.
• Be sure to indicate dates of service or date range for records needed.
• Be sure to indicate specific type of records being requested (e.g., lab results, physical therapy, emergency department, etc.).
• If records being requested are clinic records, please indicate specific clinic(s).
• Sign and date/time the request to access form (the patient or their authorized representative must sign).
• Include the FULL name and COMPLETE address to whom you would like these records sent.

To help us expedite third party requests for release of information, please take note of the following when completing the Authorization to Obtain and/or Disclose Health Information Form:

• Please print clearly.
• Be sure to indicate dates of service or date range for records needed.
• Be sure to indicate specific type of records being requested (e.g., lab results, physical therapy, emergency department, etc.).
• If records being requested are clinic records, please indicate specific clinic(s).
• Specify the reason/purpose that you are requesting these records (e.g., continued care, legal, insurance, personal reasons, etc.).
• Sign and date/time the authorization form (the patient or their authorized representative must sign).
• Include the FULL name and COMPLETE address to whom you would like these records sent.

If you have any questions regarding completing either form or about release of information in general, contact us at 860-679-2787.

How to Submit Your Request

Completed forms may be dropped off at the UConn Health Release of Information Office, 263 Farmington Avenue, Room CG177, Farmington, CT;

Business Hours: Monday through Friday, 7:30 a.m. to 5:30 p.m.

Or

Faxed to: 860-679-1273;

Or

Mailed to:

Release of Information
Health Information Management
UConn Health
263 Farmington Avenue, MC 2260
Farmington, CT 06030-2260

Patients may also submit the completed form via email to PatientROIRequests@uchc.edu.

For Third Party Requesters
Third party requesters can contact our Release of Information vendor, STAT Informatic Solutions, for follow-up questions using the following options:

STAT Informatic Solutions Customer Service at 321-206-8419 option 1

Or

Send an email to roicustomerservice@statisllc.com

For invoice payments and or to register into STAT’s Third Party Portal, please visit the STAT website.

How to Request X-ray Images

To access your own X-ray Images complete a Patient Request to Access Medical Records form. For third party requests complete the Authorization to Obtain and/or Disclose Health Information form.

For radiology images, contact the Diagnostic Imaging Department.

Phone: 860-679-2441
Fax: 860-679-1465

Business Hours: Monday through Friday 8 a.m. to 4:30 p.m.

How to Request Dental X-ray Images

To access your own dental X-ray images, complete a Patient Request to Access Medical Records form. For a third party requests, complete the Authorization to Obtain and/or Disclose Health Information form.

Completed forms may be mailed to:

Medical Records
Dental Care Center
UConn Health
263 Farmington Avenue, MC 2105
Farmington, CT 06030

Or

Faxed to: 860-679-7817

If you have any questions, please call the Dental Care Center at 860-679-2838.

Is There a Charge Associated with Requesting Copies?

Yes, be aware that there may be a charge associated with the copying of your medical records. If that is the case, you will be billed accordingly.

How to Request Copies of Billing

For billing records, call Clinical Business Services Customer Service at 860-679-6954.

How to Request Pathology Slides?

To obtain a copy of your pathology report(s) and slide(s) for the purpose of a second opinion or to transfer care, follow the steps below to help expedite the timely release of the slide(s) and written report(s):

• Complete the Authorization to Obtain and Release Pathology Slides/Reports and leave nothing blank.
• After completing the Release Form, you can:

Mail the form to:
Department of Anatomic Pathology
UConn Health
263 Farmington Avenue
Farmington, CT 06030-3985

Or

Fax the form to: 860-679-4334

Or

Bring the form to:
Department of Anatomic Pathology
UConn Health
Main Building
For directions, call 860-679-2980

If you have any questions, please call the Department of Anatomic Pathology at 860-679-2980 between the hours of 8 a.m. and 5 p.m., Monday through Friday.

UConn John Dempsey Hospital requests that payment be made prior to or at the time of service at the appointment location for any amount not covered by insurance. Insurance deductibles, co-payments, and co-insurances will be considered as deposits and are due at the time of service. The amount due is based on an estimate that may include the facility, professional, or both sets of fees; in addition this may change based on the services provided.

For patients looking for insurance options, Access Health Connecticut is our state’s health insurance marketplace, where individuals and small businesses can shop, compare, and enroll in quality healthcare plans.

For patients without insurance, the total estimated hospital bill less any initial deposits made is due upon check-in. If a patient is unable to make the full payment at check-in, financial assistance may be available, however patients should seek assistance prior to the appointment. Alternate payment options include setting up a payment plan or receiving assistance through public health insurance programs such as Medicaid or financial assistance. If patient wishes to apply for one of these programs, the patient should call Financial Counseling at 860-679-4120 and be prepared to supply the following information:

• Federal tax forms, or two months of pay stubs if W-2 is not available.
• Credit card statements if used for basic living expenses.
• Profit and loss statements from self-employed patients/guarantors.
• Documentation regarding receipt of, or payment of child support or alimony.
• Current pay stubs of disability income if applicable.

Payments can be made in cash, check, and credit and/or debit cards with the MasterCard, Visa, or Discover.

In order to understand the full impact of patient financial responsibility, it is important that you, as the patient, coordinate with your insurance company once the services likely to be provided are identified.

Contact information is listed below. Note these numbers should be utilized to make arrangements on upcoming visits only.

• To provide a payment prior to the service date, contact Registration at 860-679-1600.
• For information on financial hardship arrangements including applying for programs and payment plans, contact Financial Counseling at 860-679-4120.
• If payment will be provided at time of service, please do so at the appointment location where the service will take place.

Please note UConn John Dempsey Hospital will not condition a patient’s access to emergency treatment or labor and delivery care on an ability to pay for such treatment.

Pay your bill online now.

Billing Process

Prior to scheduled admissions, our registration staff will seek to verify your insurance coverage and benefits. As insurance coverage varies greatly, it is important for you to understand your coverage and responsibilities.

The Patient Access Department also attempts to contact insurance companies to inform them of admissions, but you or a family member should follow your insurance company's directions about notification and other managed care requirements. If insurance is not available or is inadequate, your admission will be referred to a financial counselor, who will explain your options, set up a payment plan, or help you apply for financial assistance. Financial counselors can also help interpret your insurance coverage. This is particularly important for parents of infants in the Newborn Intensive Care Nurseries.

Insurance Coverage

The patient/guarantor is responsible for knowing your insurance company coverage and what services require prior authorization. You may be responsible for payment of any balances which are denied by your insurance company. Insurance coverage is not always a guarantee of payment.

Insurance Plans Accepted

UConn Health participates with most major Connecticut health plans. Please check with your health plan provider for plan details including coverage and benefits.

Financial Assistance

UConn Health offers a financial assistance program which provides a reduced cost rate for medically necessary services incurred by State of Connecticut legal residents whose household incomes do not exceed 250% of the Federal Income Poverty Guidelines for a family unit.

Patients must meet the State of Connecticut definition of “uninsured,” and may need to apply and be denied eligibility for any medical or health care coverage provided under the General Assistance Program or the Connecticut Medicaid program, or not be eligible for coverage under the Medicare or CHAMPUS programs, or any other governmental or privately sponsored health or accident insurance. Patients must furnish proof of income to qualify.

There are financial counselors available to assist patients with the application procedure for Connecticut Medicaid, as well as financial assistance. Additionally, UConn Health has translation services available through AT&T Language Line Services to assist with this process.

View our Financial Assistance Policy.

To apply, download our Financial Assistance Application.

For additional information, call Financial Counseling at 860-679-4120.

Bill Payment

UConn John Dempsey Hospital accepts Medicare and Medicaid insurance plans and is in-network with most major insurance companies in Connecticut. We will submit your claim for payment and make every effort we can to collect payment from your insurance carrier. Please provide Patient Access with the proper and most current insurance information. UConn John Dempsey Hospital will NOT accept responsibility for collecting your insurance claim or negotiating a settlement on a disputed claim. Insurance coverage is not always a guarantee of payment.

If you need to make payment for any portion of your bill, you can contact us at the numbers provided. We can process your credit card payment over the phone as well. We can immediately submit it for approval and have it processed, and we will not store your credit card number, keeping your information secure.

Interest-free Loan Program

UConn Health offers its patients an interest-free loan program through ClearBalance®, giving our patients an affordable option to pay for their medical expenses over an extended period.

ClearBalance Program benefits include:

• Better payment options
• 0% interest program
• Easy qualification and no application
• Affordable monthly payments
• Ability to make payments over time
• No annual fees or prepayment penalties
• Friendly, accessible customer service
• Clear, consolidated monthly statement
• Add future bills
• Pay your bills 24/7 by check or credit card, via mail, phone or online at www.myclearbalance.org

For additional information, call 860-679-6387.

Revolving credit accounts are offered by Western Alliance Bank, Member FDIC. ClearBalance is a registered service mark of CSI Financial Services, LLC, which provides certain account servicing functions for the bank.

Physician Services

You may also be billed for physician services during your stay. If you have questions about your physician bill, please call University Physicians at 860-679-6387 or your private physician who is not employed by UConn Health.

Frequently Asked Questions

Please see our Frequently Asked Questions.pdf for additional information about billing and financial services.

Contact Information

Mailing Address:
Patient Financial Services
John Dempsey Hospital
UConn Health
P.O. Box 4034
Farmington, CT 06034-4034

In Person:
Patient Financial Services
16 Munson Road, 1st Floor
Farmington, CT 06034-4034
Hours: 8 a.m. to 4 p.m.

Phone: 860-679-6387
Monday through Friday, 8:30 a.m. to 4:15 p.m.
(Voicemail available after regular business hours)

Fax: 860-679-4237

Email: jdhpatientfinancialservices@uchc.edu

UConn Health can provide a price estimate – a prediction of what your future procedure or treatment will cost and how much you may be responsible for paying based on your insurance coverage.

How Accurate Are Estimates?

UConn Health works hard to provide accurate estimates. However, it is important to understand that because of the personalized nature of health care, patient differences, and the potential for unforeseen complications we cannot provide an estimate guarantee.

Factors that may alter your actual out of pocket costs include, but are not limited to, the following:

• Variations in the services and codes estimated
• Receiving different services than those included in the estimate (i.e., additional labs, imaging, certain professional fees, anesthesia)
• Receiving health care services at any UConn Health location or another health care facility between the date the estimate was created and your date of service (i.e., your remaining deductible may change over time)
• The insurance coverage selected. If you have secondary coverage, your out of pocket cost will not reflect additional coverages.

If you have any questions, please contact Financial Counseling at 860-679-4120.

• UConn John Dempsey Hospital Price List
• Online Estimate Tool

• Authorization to Obtain and/or Disclose Health Information
• Authorization to Obtain and Release Pathology Slides/Reports
• Consent for Treatment, Use and Disclosure of PHI, Acknowledgments and Financial Agreement Form
• Financial Assistance Application