Financial Assistance – Patients

[Pages:2]Financial Assistance ? Patients

Policy and Procedure

Purpose

BayCare Health System hospitals are not-for-profit entities established to meet the health care needs of the residents of the communities they serve. Accordingly, the hospitals provide care for emergency medical conditions, without discriminations, regardless of the patient's financial assistance eligibility. The hospitals also provide other medical care services to certain individuals for which they receive no payment. This policy will provide a systematic method for identifying and distributing uncompensated care (charity) to the residents of the community.

Policy

BayCare Health System will provide charity care to hospital patients that are determined, as part of an application process, unable to pay for services due to financial hardship. Two programs are used to qualify patient for charity: 1. AHCA Charity, under guidelines established by the State of Florida, is available to patients with family incomes under 200% of the federal poverty level or whose hospital related expenses exceed 25% of the annual family income; 2. Hardship Charity, under guidelines established by BayCare Health System, extends beyond AHCA charity limits and includes patients with family income up to 250% of the federal poverty level. Reasonable efforts to notify patients that they may qualify for financial assistance and how to apply include postings in the Admitting Office, emergency rooms, other registration sites, plain language summary of the policy offered at discharge, an alert on billing statements, and the policy will be posted on each facility's website. Free copies of this policy can

Continued on back

n Policy Number: BC ADM 06 n Issued: January 1, 2014 n Approved by: John Gantner,

BayCare CFO



be obtained at each facility's Admitting

prior or subsequent months to

and Financial Assistance office. Patients

the date of service under review.

that have submitted complete financial

iii. Charges not covered under

information and qualified for charity

Medicaid as part of the patient's

will not be subject to any billing and/

share of cost.

or collection efforts, and the patient

iv. Patient referred from community

responsibility will be discounted to

organizations which have

zero. In addition, hospitals provide

agreements with individual

care for emergency medical conditions

hospitals to provide specific

for patients regardless of source of

services to identified patients

payment or lack of insurance coverage

with no charge to the patient,

and no requests for payment will be

e.g. community Free Clinics,

made before a medical screening is

Mammography Voucher

completed. Financial Assistance team

program. Every effort will be

members will be available to patients

made to obtain a financial

during designated times to assist patients

assistance application form to

with determining their eligibility for

consider for AHCA charity.

Federal, State and County financial

These patients will be considered

assistance programs. Final authority

as Hardship Charity in the

for determining eligibility for financial

absence of the screening form

assistance lies with the Director of

or if they do not meet AHCA

Financial Assistance.

guidelines.

1. Criteria used to determine a patient's c. E xceptions may be made for

eligibility for charity are as follows:

individuals exceeding the above

a. Florida Agency for Health Care

criteria when there is a well-

Administration Charity Guidelines:

documented financial hardship

Family income for the 12 months

or extenuating circumstances, e.g.

preceding the determination does

projected decrease of income due to

not exceed 200% of the current

catastrophic illness or injury.

Federal poverty guidelines, and/or 2. M ethod for applying for financial

the unpaid portion of the hospital

assistance: Applications for financial

bill due from the patients exceeds

assistance can be obtained on the

25% of the annual family income.

facility's website and at the Admitting

The total family income cannot

and Financial Assistance Offices. In

exceed four times the federal

addition, a request for mailing the

poverty level for a family of four

application can be made by calling

regardless of the charges due from

(855) 233-1555 or printed directly

the patient

from the organization's website.

b. BayCare Hardship Charity if he/she Documentation that may be required

meets at least one of the following

to determine eligibility is as follows:

guidelines:

a. S igned financial assistance

i. A financial assistance application

application acknowledging that

form with income information

providing false information

indicating family income < 250%

to defraud the hospital is a

of FPL.

misdemeanor in the second degree

ii. Adequate documentation of

(Section 817.50 F.S.)

income and assets in order to

b. Income documented by one of the

make a determination of the

following: W-2 withholding forms,

patient's inability to meet his/her

employer paystubs, previous year

financial obligations. This could

federal tax return, verification of

include patients with Medicaid or

current wages from employer(s),

County eligibility in immediately

from public welfare agencies or

other governmental agency which can attest to the patient's income status for the past 12 months. c. A Medicaid remittance voucher which reflects that the patients' Medicaid benefits for the Medicaid fiscal year have been exhausted. d. V erification of Medicaid coverage for patients that have Medicaid as secondary to Medicare. 3. Once a patient submits a complete application for financial assistance anytime during a year after the service, collection efforts will be halted until a determination of eligibility has been finalized. Should the patient submit an incomplete application, he/she will be notified which necessary information is missing with a copy of the plain language Financial Assistance Policy. This includes collection efforts by the BayCare Central Business Office, and primary and secondary collection agencies. Patients who qualify for financial assistance will have their complete balance adjusted to zero, collection efforts will cease permanently, and notice will be sent to any credit bureau where adverse information had previously been reported. 4. Uninsured patients not qualifying for financial assistance will qualify for a 40% discount from billed charges and additional 10% discount if paid in full within 30 days of the first statement in accordance with the Uninsured Patient Discount Policy. All patients with outstanding balances will be subject to standard collection processing and may result in turnover to a collection agency according to the Collections ? Patient Financial Responsibility Policy. These policies may be obtained by calling (727) 734-6550.

BC1401916-0414



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