Registration

Outpatient Registration is located in the front entrance of the hospital. Park in the main parking lot and enter through the main entrance.

Outpatient Registration Hours:
Monday-Friday 8:00am-4:30pm
Outpatients must register at the ER registration desk after hours.

Emergency Department Patients park in the ER parking lot and enter through ER entrance.

The following items are needed at the time of registration:
• Physician Order (outpatient registration only)
• All active insurance cards
• Picture ID
• Living Will, Advance Directives, Durable Power of Attorney
• Payment for your co-pay or deductible – cash, check and credit card accepted

Open to patients and visitors for breakfast and Lunch
Breakfast 6:00am-10:00am
Lunch 11:30am – 2:00pm
Guest trays are available for family members who wish to share meals with patients for a fee of $6.99
Vending machines are located by Outpatient Registration
If you need to obtain copies of your medical records, please print and complete the Medical Records Release Form and fax it to the number or address below.

Medical Records Release Form

Lake Butler Hospital
Attn: Medical Records

850 East Main Street
Lake Butler, FL 32054
Fax: (386) 496-4734

If you wish to drop it off, you can turn it in to the receptionist located at the front desk in the main lobby Monday-Friday 8:00am-5:00pm.
Please allow 3-5 days to complete your records request.

If you have questions or to check the status of your records request call (386) 496-2323 ext. 9240

PATIENT BILL OF RIGHTS AND RESPONSIBILITIES

Florida law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider’s or health care facility’s right to expect certain behavior on the part of patients.  You may request a copy of the full text of this law from your health care provider or health care facility.  A summary of your rights and responsibilities follows:

  • A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity and with protection of his or her need for privacy and to be called by their proper name.
  • A patient has the right to receive care in a safe environment, free from all forms of abuse, neglect or mistreatment, and may request an escort during any type of exam.
  • A patient has the right to a prompt and reasonable response to questions and requests.
  • A patient has the right to know who is providing medical services and who is responsible for his or her care.
  • A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
  • A patient has the right to know what rules and regulations apply to his or her conduct.
  • A patient has the right to have a family member or person of your choice and your own doctor notified promptly of your admission to the hospital.
  • A patient has the right to have someone remain with you for emotional support during your hospital stay, unless your visitor’s presence compromises your or others’ rights, safety or health.  You have the right to deny visitation at any time.
  • A patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
  • A patient has the right to refuse treatment, except as otherwise provided by law.
  • A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.
  • A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.
  • A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.  The Agency for Health Care Administration makes available data on hospital prices and performance at http://www.floridahealthfinder.gov. Pricing and performance data provided by AHCA are a compilation of charges for the average patient, and your bill may vary from the average depending upon the severity of your illness and your individual care needs.
  • A patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have charges explained.  
  • A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap, or source of payment.
  • A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.  
  • A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
  • A patient has the right to express grievances regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
  • A patient has the right to be informed and participate in his or her plan of care.  This includes formulation of Advanced Directives or to appoint someone to make health care decisions for them if they are unable, and to have hospital staff and practitioners who provide care, comply with these directives. If they do not have an advanced directive, the hospital can provide them with information and help them complete one.
  • A patient has the right to have their pain assessed and to be involved in decisions about treating your pain.
  • A patient has the right to be free from the use of seclusion and restraint, of any form, as a means of coercion, discipline, conveniences, or retaliation of staff.

PATIENT’S RESPONSIBILITIES

  • A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.
  • A patient is responsible for providing complete and accurate information, including their full name, address, home telephone number, date of birth, Social Security number, insurance carrier and employer when required.
  • A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.
  • A patient is responsible for actively participating in their pain management plan and to keep their health care provider informed of the effectiveness of your treatment.
  • A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
  • A patient is responsible for following the treatment plan recommended by the health care provider.
  • A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.
  • A patient is asked to leave valuables at home and bring only necessary items for their hospital stay.
  • A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
  • A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
  • A patient is responsible for following health care and facility rules and regulations affecting patient care and conduct, and be mindful of noise levels, privacy, and number of visitors.

FILING COMPLAINTS

If you have a problem or complaint, you may talk to your doctor, practitioner, nurse manager or department manager.  You may also contact the Chief Operating Officer at (386) 496-9227 or email jthomas@lakebutlerhospital.com

If your concern is not resolved to your liking, you may also contact the following:

Agency for Health Care Administration Centers for Medicare and Medicaid Services
Bureau of Health Facility Regulation Medicare Web Site
2727 Mahan Drive, Mail Stop #31 www.medicare.gov
Tallahassee, FL. 32308 1-800-Medicare
(850) 487-2717 1-800-633-4227

 

PROYECTO DE LEY DE PACIENTE DE DERECHOS Y RESPONSABILIDADES


La ley de Florida requiere que su proveedor de atención médica o centro de atención de la salud reconozcan sus derechos mientras usted está recibiendo atención médica y que se respete el proveedor de atención médica o centro de atención a la salud es el derecho a esperar un determinado comportamiento por parte de los pacientes. Usted puede solicitar una copia del texto completo de esta ley a su proveedor de atención médica o centro de salud. Un resumen de sus derechos y responsabilidades siguientes:

ϖ El paciente tiene el derecho a ser tratado con cortesía y respeto, con reconocimiento de su dignidad individual y con la protección de su necesidad de privacidad y ser llamados por su nombre propio.
ϖ El paciente tiene derecho a recibir atención en un ambiente seguro, libre de toda forma de abuso, abandono o maltrato, pudiendo solicitar una escolta durante cualquier tipo de examen.
ϖ El paciente tiene el derecho a una respuesta pronta y razonable a sus preguntas y solicitudes.
ϖ El paciente tiene el derecho a saber quién está proporcionando servicios médicos y quién es responsable de su cuidado.
ϖ El paciente tiene el derecho a saber cuáles son los servicios de apoyo al paciente están disponibles, incluyendo si hay un intérprete disponible si él o ella no habla Inglés.
ϖ El paciente tiene el derecho de saber qué reglas y regulaciones se aplican a su conducta.
ϖ El paciente tiene el derecho de tener a un familiar o persona de su elección y su propio médico notifique oportunamente de su admisión en el hospital.
ϖ El paciente tiene el derecho a que alguien permanezca con usted para apoyo emocional durante su estancia en el hospital, a menos que la presencia de su visitante o pone en peligro tu “otros derechos, la seguridad o la salud. Usted tiene el derecho de negar la visita en cualquier momento.
ϖ El paciente tiene el derecho a ser dado por el diagnóstico médico proveedor de información relativa a, plan de tratamiento, alternativas, riesgos y pronóstico.
ϖ El paciente tiene el derecho a negarse al tratamiento, excepto en los casos previstos por la ley.
ϖ El paciente tiene el derecho a recibir, previa solicitud, la información completa y el asesoramiento necesario sobre la disponibilidad de recursos financieros conocidos para su cuidado.
ϖ Un paciente que es elegible para Medicare, tiene el derecho a saber, si lo solicita y, antes del tratamiento, si el proveedor de cuidado de salud o centro de atención de salud acepta la tarifa asignada de Medicare.
ϖ El paciente tiene el derecho a recibir, previa solicitud, antes del tratamiento, un estimado razonable del costo de la atención médica. La Agencia para la Administración del Cuidado de la Salud hace que los datos disponibles sobre los precios y el desempeño del hospital en http://www.floridahealthfinder.gov. Datos sobre los precios y el rendimiento proporcionado por AHCA son una recopilación de los cargos para el paciente promedio, y su factura puede variar respecto a la media, dependiendo de la gravedad de su enfermedad y sus necesidades de atención individual.
ϖ El paciente tiene el derecho de recibir una copia de un razonablemente clara y comprensible, factura detallada y, previa solicitud, para hacer cargas explicar.
ϖ El paciente tiene el derecho a tener acceso imparcial a tratamiento médico oa instalaciones independientemente de su raza, origen nacional, religión, discapacidad física o fuente de pago.
ϖ El paciente tiene el derecho a recibir tratamiento para cualquier condición de emergencia médica que puede deteriorarse si no le da tratamiento.
ϖ El paciente tiene el derecho a saber si el tratamiento médico es para fines de investigación experimental y dar su consentimiento o negativa a participar en dicha investigación experimental.
ϖ El paciente tiene el derecho de expresar sus quejas sobre cualquier violación de los derechos que le afecte, como se establece en la ley de Florida, a través del procedimiento de quejas del proveedor de atención médica o centro de salud que sirve a él o ella ya la agencia estatal de licencias correspondiente.
ϖ El paciente tiene el derecho a ser informado y participar en su plan de atención. Esto incluye la formulación de directrices anticipadas o designar a alguien para que tome decisiones de atención médica para ellos si no son capaces, y que el personal del hospital y los médicos que brindan atención, cumplir con las mismas. Si no tiene una directiva anticipada, el hospital puede proporcionarle información y ayudarles a completar una.
ϖ El paciente tiene el derecho a que su dolor evaluado y de participar en las decisiones sobre el tratamiento de su dolor.
ϖ El paciente tiene el derecho a estar libre del uso de la reclusión y la restricción, de cualquier forma, como medio de coerción, disciplina, comodidad o represalia del personal.

RESPONSABILIDADES DEL PACIENTE

ϖ El paciente tiene la responsabilidad de proporcionar al proveedor de servicios de salud, a lo mejor de su conocimiento, información precisa y completa sobre sus dolencias actuales, enfermedades pasadas, hospitalizaciones, medicamentos y otros asuntos relacionados con su salud.
ϖ El paciente tiene la responsabilidad de proporcionar información completa y precisa, incluyendo su nombre completo, dirección, número de teléfono, fecha de nacimiento, número de Seguro Social, la compañía de seguros y el empleador cuando sea necesario.
ϖ El paciente es responsable de reportar cambios inesperados en su condición ante el proveedor del cuidado de la salud.
ϖ El paciente es responsable de participar activamente en su plan de manejo del dolor y de mantener su proveedor de atención de salud informó de la eficacia de su tratamiento.
ϖ El paciente tiene la responsabilidad de informar al proveedor de cuidados de salud si él o ella comprende un curso de acción y lo que se espera de él o ella.
ϖ El paciente es responsable de seguir el plan de tratamiento recomendado por el médico.
ϖ El paciente es responsable de sus citas y, cuando él o ella es incapaz de hacerlo por cualquier razón, de notificar al médico o centro de atención de la salud.
ϖ Un paciente se le pide que deje objetos de valor en casa y traer sólo los elementos necesarios para su estadía en el hospital.
ϖ El paciente es responsable de sus acciones si él o ella se niega el tratamiento o no sigue las instrucciones del proveedor de atención médica.
ϖ El paciente es responsable de asegurarse que las obligaciones financieras de la atención de su salud se cumplan tan pronto como sea posible.
ϖ El paciente es responsable de seguir las reglas de cuidado de la salud y de las instalaciones y regulaciones que afectan la atención al paciente y la conducta, y ser conscientes de los niveles de ruido, la privacidad, y el número de visitantes.

PRESENTACIÓN DE QUEJAS

Si usted tiene un problema o una queja, usted puede hablar con su doctor, enfermera jefe o gerente de departamento. También puede comunicarse con el Director público / relaciones con el paciente en (386) 496-9227 o correo electrónico jthomas@lakebutlerhospital.com

Si el problema no se resuelve a su gusto, también puede comunicarse con los siguientes:

Agencia de Administración de Cuidado de Salud Centros de Servicios de Medicare y Medicaid
Oficina de Instituciones de Salud Reglamento del sitio web de Medicare
2727 Mahan Drive, Mail Stop # 31 www.medicare.gov
Tallahassee, FL. 32308 1-800-Medicare
(850) 487-2717 1-800-633-4227

Pricing Estimates and Discount Policies-Uninsured

In keeping with our mission to assist our community with their medical needs, Lake Butler Hospital offers various forms of financial assistance for uninsured patients in need of emergent and non-elective services.  

Financial Counseling Services: To assist us in evaluating which program best fits your particular needs, we have a Patient Access Supervisor on hand Monday through Friday, 8:00am through 5:00pm.  They are available to assist you in completing the application needed to screen you for various Local and State Programs, including Health Care Responsibility Act and Medicaid and answering any questions you may have.  In addition you may be screened for eligibility in meeting Lake Butler Hospital’s Charity Discount Policy click here. Additionally, for uninsured individuals who do not qualify for any other programs or the Hospital’s Charity Discount Policy, they may qualify under the hospital’s Self Pay Discount Policy click here.

Payment: If you do not qualify for any of these programs due to your financial status and cannot pay for the healthcare services you need at the time of your visit, we will work with you to set up monthly payment arrangements. We accept all major credit cards, checks, money orders and cash for payment of your services.

Advanced Estimates and Charge Information: If you are interested in receiving a written advanced estimate of the Hospital’s charges for the services you need, please contact our Patient Access Supervisor at (386) 496-2323, ext 9206 or Click Here to fill out the Price Estimate Form online. We will need to know as much information as possible about the services you are interested in receiving, such as, if you are expected to be admitted for treatment overnight, or if you are expected to be treated on an outpatient basis. We have a full copy of the hospital’s charges available for you to review in our Patient Access Department, which you can request to review at any time, before or during your Registration. Click here for a summary of pricing for the most frequently requested and utilized items/services at Lake Butler Hospital.

Once we receive your request for a written advanced estimate, we will review your request against the hospitals charges and/or historical data to provide as close an estimate as possible for your requested services.  Due to the many complexities in hospital charge structures, the exact charges for your services may not match those of other patients due to unforeseen complications, additional diagnostic tests or procedures that may be specific to your care, or non-hospital related charges, any of which may change the ultimate cost of the services provided.  In light of this fact, please understand that the advanced estimate provided may not match exactly with the amount included in your final billing and that Lake Butler Hospital shall not be liable for any inaccuracies.   We assure you that our advanced estimate will be as accurate as possible considering the information you provided to us in advance of your services.

Privacy Policy

Upon admission, you will receive a copy of the Lake Butler Hospital’s Notice of Privacy Practice, which identifies your rights to privacy and the ways in which the hospital works to protect your privacy.  If you object to having your name in the hospital’s patient directory, or if you would like to limit or restrict communications with persons involved in your care or payment of services, it is your responsibility to inform hospital personnel of that decision.  You may make or rescind this decision at any time during your hospital stay.

Click here to view our Notice of Privacy Practices document to read about how health information about you may be used and disclosed and how you can get access to this information.

Contracted Insurance Plans and Providers Listing

Below is a list of health insurance providers/carriers that have a contractual relationship with Lake Butler Hospital as of 06/01/16. 

The hospital accepts assignment of many other insurance providers/carriers that are not specifically listed herein, but the benefits may be paid at out-of-network pricing, or may require prior negotiation.  Therefore, please contact the Patient Access Supervisor at (386) 496-9206 to receive specific information on the financial pricing for your insurance plan.

Below is a list of contracted health care providers who provide various healthcare services that are not directly provided by the hospital’s employees.  These services may or may not be necessary in the treatment of your specific healthcare needs.  In the event you are in need of those services that are provided by one of these contracted health care providers, you will be billed separately from the hospital for those services.  If you are interested in an estimate for those services, please contact the Patient Access Supervisor at (386) 496-9206 and we will assist you with this process.

  • Solstice Pathology Services
  • LabCorp Reference Laboratory Services
  • Quest Reference Laboratory Services

Smoking & Tobacco Policy

LBH is a tobacco free campus. Use of any tobacco product is prohibited on the property. We will appreciate your cooperation.