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.

The Health Information Management Department maintains confidential records of your treatment for all your care. The records are the property of UConn Health, however, patients may access copies of their medical records if needed for any reason. If you should require a copy of your medical records following your care, your request must be in writing.

How Do I Obtain a Copy of My Medical Records?

All copies of medical 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.

UConn Health now offers patient portals as a means for on-line viewing or printing of select portions of your medical records. If you have been an inpatient at UConn Health and/or are a patient in one of our outpatient practice locations, log on to MyChart for more information on accessing your information.

Other forms of health information such as X-ray images and lab slides not considered part of your medical records must be requested from those specific departments in which they reside (Radiology Department, Laboratory Medicine Department) see below.

Also, be advised that your medical records does not contain billing information. Contact the Patient Financial Services Department to obtain copies of billing records you may need. See below.

You may obtain copies by completing the Authorization to Obtain and/or Disclose Health Information.pdf in order to allow for disclosure of your records to yourself or to another entity.

To help us expedite your request for release of information, please take note of the following when completing this form:

• Please print clearly.
• Be sure to indicate dates of treatment for records needed.
• Be sure to indicate specific type of records being requested (e.g., lab results, physical therapy, emergency department).
• If records being requested are clinic records, please indicate specific clinic(s).
• Specify the reason that you are requesting these records (e.g., continued care, legal, insurance, personal reasons, etc.).
• Sign the authorization form (the patient must sign for their own medical records, in the case of a minor the parent or legal guardian must sign).
• Include the FULL name and COMPLETE address to whom you would like these records sent.

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

Once completed, this form may be dropped off at the UConn Health Release of Information Office, 263 Farmington Avenue, Room CG177, Farmington, CT; 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

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

For Third Party Requestors
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 Do I Go About Obtaining X-ray Images?

You may obtain copies by completing the Authorization to Obtain and/or Disclose Health Information.pdf in order to allow for disclosure of your X-ray images to yourself or to another entity.

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.

Is There a Charge Associated with My Request for 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 Do I Go About Obtaining Other Non-medical Record Information Like Dental Record and Films, Lab Slides, and Billing Records?

For UConn John Dempsey Hospital billing records, call 860-679-2795.

For UConn Medical Group billing records, call 860-679-2689.

For dental records and films, call 860-679-8310.

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.pdf 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 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.

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

Effective January 1, 2019, to comply with the federal requirements enacted as part of the Affordable Care Act, UConn Health is providing an on-line list of standard charges. Every effort has been made to ensure the accuracy of prices displayed.

The cost of care has many variables including the many differences in health insurance benefit plans, discounts, and the unique needs of each patient. The financial responsibility can be different for each patient.

If you are insured, please be sure to contact your health insurance provider to review your benefits and request your financial responsibility based on your plan.

If you are not insured, please call our financial counselors at 860-679-4120 for price estimates and to discuss payment options. For more on our charity care policy and application, see Billing & Insurance on the Patient Resources page.

Note:

• A single charge may not represent all that is included in a medical service due to many components it takes to complete each service.
• The pricing is for the hospital component only. There may be professional fees related to services rendered.

UConn John Dempsey Hospital Price Lists

Diagnosis Related Group (DRG) Average Charges        Current Hospital Standard Charges

• 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