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Billing Questions?

Answers to billing questions can be obtained by contacting the billing department:

Monday – Friday
8:00am to 4:30 pm

Phone: (575) 472-3417 ext. 1013 or 1014
Fax: (575) 472-4587

Need Assistance 
If you have questions or require assistance completing this application, please contact the business office:

Elena Tenorio - (575) 472-3417 ext. 1014
Christine Sanchez - (575) 472-3417 ext. 1013

 


Insurance Information

If you need to report updated insurance information, please complete the form below or contact admissions at:

Pablita Abeyta - (575) 472-3417 ext. 1000
Gina Sena - (575) 472-3417 ext. 1001

Insurance Information Update Form

If you wish to update your Insurance Information online; then, please click the link below.

Before updating your information online, please have an electronic copy (image or pdf) of your insurance card (front and back).

A valid email account is required to complete the online form.

Insurance Information Update Online


How to Pay a Bill

By mail – Send a personal check, traveler's check or money order to:
Guadalupe County Hospital, 117 Camino de Vida, Suite 100, Santa Rosa, NM 88435.

By phone – Call (575) 472-3417 ext. 1000 or 1001 to use your credit card or debit card.

In person – Guadalupe County Hospital, 117 Camino de Vida, Suite 100, Santa Rosa, NM 88435

Automatic Payment- Complete the form below:

Automatic Credit/Debit Payment Authorization Form

Guadalupe County Hospital accepts, Visa, Master Card, Discover, American Express and bank debit cards.

If you wish to submit the automatic payment authorization form online; then, please click the link below.

A valid email account is required to complete the online form.

Automatic Credit/Debit Payment Authorization Form Online


GCH Care Discount Program

Guadalupe County Hospital is dedicated to the health and welfare of the community and to ensuring that each person has access to quality and compassionate medical care, regardless of ability to pay.  GCH offers financial assistance to un-insured or under-insured GCH patients in the form of discounts, based on annual household incomes and household size. 

Notice:
Guadalupe County Hospital has revised its current discount program for patients who cannot afford to pay full price for medical care.  If you are currently enrolled with the previous discount program, you can re-apply and have your account revisited for a possible reduction.  You will have to complete a new application and provide current proof of household income (ex. pay stubs, W2’s, income tax).

Listed below is the income range for our Revised GCH Care Program.
2018 Annual Gross Income Range for each Sliding Fee Percentage Category

 
GCH Care Table.png
 

We will notify you within (30) days if your GCH Care discount application has been approved or denied.  If you qualify for the discount, it will be applied to current balances.  If you are denied, you may appeal the denial or reapply for the discount at any time your financial situation changes.

If you have any question regarding the GCH Care discount program, you can contact Elena Tenorio (ext. 1014) or Christine Sanchez (ext. 1013) at 575-472-3417.

GCH Care Application

You may mail or drop-off in person your application and documentation to:

Guadalupe County Hospital
117 Camino de Vida, Suite 100
Santa Rosa, NM 88435

GCH Care Application Online

Prior to starting your online submission, you will need to have applicable documentation available in electronic format that will be attached to your application. Applicable documentation include:

Insurance

  • Medical Insurance

  • Medicaid

Income Verification

  • Pay Stubs (two most recent)

  • Income Tax Return


Charge Description Master (CDM) Price Transparency

Many factors influence the actual cost of a service, such as type of insurance coverage, as many times rates are negotiated with payers and may not reflect the standard charge. The cost of treatment may also be impacted by variables involved in a patient’s care, such as equipment, supplies, length of recovery, additional tests, or sometimes unexpected complications.

There may be additional fees by third party facilities for services such as pathology and radiology. These charges are billed separately.

Please contact the Billing Department to obtain an estimate on charges at (575) 472-3417 ext 1013 or 1014

Disclaimer: Guadalupe County Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

GCH CDM