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Pay Your Bill Patient Portal

Medical Record Request


Your medical record is a confidential document. You have a right to view or have copies of your record as outlined in The Montana Uniform Health Care Information Act and HIPAA Federal Privacy Regulations. To obtain a Medical Record Request Form, visit the front registration desk at Ruby Valley Medical Center. You can also download the form by clicking on an option below, print, complete, and then either mail or drop off in person at RVMC's front registration desk.​​

*Important Instructions - Please Note:

  • Please make sure to fill out the form completely in order to ensure the request is processed quickly and efficiently.
  • Please make sure to sign, print and date in the bottom right hand corner.
  • Requests are good for up to a year, and can be ongoing.  Please make sure to specify what records need to be sent/received with a specific date if necessary, or note if it will be an ongoing process (ie: all lab work will be sent to Dr. Joe)
  • Also please note that email is not encrypted so any personal information is not necessarily protected. Please drop the forms off at the front registration desk or send via mail. **Please do not email the completed forms.**

Please contact the Health Information Management Department at (406) 842-5453 for medical record questions.

cloud_download Medical Release Form

Price Transparency

The Centers for Medicare and Medicaid (CMS) established guidance for hospitals to make available a list of their standard charges online. Ruby Valley Medical Center (RVMC) supports health care pricing transparency and tools that help patients and consumers evaluate what care is best for them and any related financial costs.  You have reached the federally-required section of our website that contains the charges for the services we provide within our facility. Click below to view the standard charges for RVMC relevant to the CMS guidance; these charges will be updated periodically and are subject to change. While we provide this information to comply with federal regulations, healthcare billing is complex. It is extremely important for you, as the consumer, to understand that standard charges may not be a relevant starting point for estimating what costs you may incur during an episode of care, and the amount actually paid by a patient will depend on that patient’s insurance coverage, policy provisions and other factors. Everyone’s case is different based on that patient’s medical condition. Please contact the hospital directly for more information regarding your specific financial responsibility at 406-842-5453.

Price Transparency

Estimate Hospital Costs

Use our simple Pricing Estimator to calculate potential costs of surgery, outpatient visits, and more. Our calculator factors in essential information such as insurance type, deductibles, and more to provide an accurate estimate of potential medical costs. 

The staff in the Billing & Financial Services office can assist you with information about your bill, submitting your insurance claim, and resources to help with the cost of your healthcare.  If you have questions about your bill or your health insurance reimbursement, please call us at 406-842-5453 and ask for the Billing Office.  We offer a Sliding Scale Program for the Clinic, a Financial Assistance Program for Ruby Valley Medical Center healthcare expenses, payment arrangements, and accept credit card payments.

The Ruby Valley Medical Center understands that medical bills typically aren't expected.  Please contact us early to ensure timely submission of your insurance claim and to make payment arrangements.  You will receive a 10% discount on the balance owing if your account is paid in full within 30 days of the service.  If you are unable to pay your account in full, listed below is our fee payment schedule.  If you are financially unable to make payment according to our fee schedule, it is your responsibility to contact our business office as soon as possible to make other financial arrangements.

Outstanding Charges

Up to $75.00

$76.00 to $300.00

$301.00 to $500.00

$501.00 to $1000.00

$1001.00 to $1500.00

$1501.00 to $2000.00

$2000.00 or above

Minimum Monthly Payment

Payment in full

$50.00 per month

$75.00 per month

$100.00 per month

$150.00 per month

$200.00 per month

Paid in 12 months

Pricing Estimator Tool

Healthcare Expense Assistance Programs

Healthy Montana Kids - Offers free or low-cost health coverage for children and teenagers up to age 19. 

Ruby Valley Medical Clinic Sliding Scale Program - This program is for individuals who feel they may need assistance to fulfill their financial obligation for visits at the Ruby Valley Medical  Clinic or Twin Bridges Medical Clinic. Please complete the form and contact the Billing Office at 406-842-5453 to apply for this program.

cloud_download Clinic Sliding Scale Form

Ruby Valley Medical Center Financial Assistance - You may qualify for our financial assistance program for the healthcare services you receive while at the hospital. Services available for the discount program include: Inpatient, Skilled nursing, Lab testing, Radiology and Diagnostic testing, Therapy, Pharmaceuticals, and Emergency Room care.  You can download a copy of the application form below and return and return to the Business Office. Please contact the Billing Office at 406-842-5453 for questions and to apply for this program.

cloud_download Hospital Financial Assistance Application

Medicare - Medicare is health insurance for people 65 or older. You’re first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease).  

Medicaid - Montana Medicaid and HMK Plus are healthcare benefits for eligible low-income Montanans. Montana Medicaid and HMK Plus pays for services that are:

  • Medically necessary,
  • Provided by a Montana Medicaid/HMK Plus enrolled provider, and
  • Medicaid/HMK Plus covered services.