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. • � � <br /> � � <br /> St. JO�Iri S <br /> Hospital ,..celebrating 125 years of healing presence <br /> 800 E.Carpenter Street • Springfield,Illinois 62769 <br /> (21�544-6464 • www.st-johns.org <br /> November 26, 2001 <br /> Jennifer Bollinger <br /> Consociate Care <br /> P.O. Box 1068 <br /> Decatur, IL 62525 <br /> Dear Jennifer: <br /> Below is a reimbursement Agreement between St. John's Hospital and City of Decatur, which <br /> will provide a discount on charges incurred by Members of City of Decatur's Employee Health <br /> Plan: <br /> • St. John's Hospital inpatient and outpatient charges incurred by City of Decatur <br /> members will be discounted 15% off total billed charges. Outpatient services include <br /> general outpatient services, Skilled Nursing Care, Hospice Care, Home Health Care, <br /> Home Infusion Therapy, Libertas substance abuse services, Wellness Care, and the <br /> Mind/Body Medicine Program. <br /> • City of Decatur Members will be entitled to in-network PPO benefits for services <br /> provided at St. John's Hospital. This may result in lower deductibles, coinsurance, or <br /> out-of-pocket expenses. <br /> • Payment of claims to St. John's Hospital by City of Decatur or its third party <br /> administrator will be within thirty(30) days of receipt of a clean claim or discount <br /> will be forfeited. <br /> • This Agreement is confidential and will be disclosed only upon the prior written <br /> notice of both parties. <br /> • This Agreement is effective November 1, 2001 through October 31, 2002 and will <br /> automatically renew annually thereafter, unless either party gives the other party <br /> notification of termination at least sixty(60) days prior to the renewal date. <br /> � An Affiliate of Hospital Sisters Health System <br />