Charity Care Policy

Springhill Medical Center and Clinics are committed to providing a comprehensive range of medical care in its non-profit, primary care facilities. Its health services, as well as active outreach specialties, are developed to meet individual needs and improve the health status of the people it serves.

Objective

Springhill Medical Center and Clinics Charity Care has been developed to ease the cost of services provided by SMC and its clinics to patients who do not have the financial means to pay for all or a portion of the charges and who meet eligibility requirements. Charity Care excludes elective care and cosmetic procedures that do not lead to a direct medical benefit.

Nondiscrimination

Springhill Medical Center and Clinics Charity Care will be applied equally, a patient account will be considered for Charity Care on an individual basis without regard to sex, age, race, color, national origin, sexual orientation, gender identity, disability, source of income or if services are covered under Medicare, Medicaid or the Children's Health Insurance Program (CHIP).  
 

Policy

In support of our values of integrity, trust, respect, compassion and stewardship, Springhill Medical Center Hospital and hospital based clinics are providing a discount on billed charges to patients for medically necessary care delivered to those who are uninsured and ineligible for government programs, or are otherwise medically indigent.

 

Clinics will strive to ensure that the financial capacity of people who need medically necessary services does not prevent them from seeking or receiving care.  The discount program is not considered to be a substitute for personal responsibility, and patients are expected to cooperate with the procedures to obtain the discount and to contribute to the cost of their care based on their individual ability to pay. 

 

  1. The Clinics will pursue payment from the patient/guarantor for all deductibles, co-pays, coinsurance, and/or services not covered by insurance or other third-part payer.

 

  1. The Clinics have a Financial Assistance Policy established to provide financial support to uninsured/under-insured patients who are unable to meet personal payment responsibilities and who meet established criteria.  The determination that a patient or patient’s guarantor needs financial assistance for these financial responsibilities may be made before or after services are rendered. Patient/guarantor must provide documentation for the need for financial assistance within 14 days of initiating the application process. A failure to provide this documentation within 14 days will result in the expiration of the application.

 

  1. The Clinics will pursue all possible forms of third-party payment such as insurance, state Medicaid programs, and county indigent care programs before granting financial assistance.  Patients/guarantors are expected to assist with all such efforts to obtain third-party payment.

 

  1. The key elements of this policy will be communicated to the public through such as the Hospital’s web site and information packets distributed at registration.

Procedure 

A. Financial Assistance

 

  1. Where possible, prior to the registration of the patient, a financial counselor will conduct a pre-registration interview with the patient, the guarantor, and/or his/her legal representative.  If a pre-registration interview is not possible, this interview should be conducted upon registration/admission or as soon as possible thereafter.  In the case of an emergency admission, the evaluation of payment alternatives should not take place until the medical care required to stabilize the patient has been provided.                                                                                                                                               

  2. The need for financial assistance shall be re-evaluated at each subsequent time of services if the last financial evaluation was completed more than 1 year prior, or at any time additional information relevant to the eligibility of the patient for financial assistance becomes known. Request for financial assistance shall be processed promptly and Springhill Medical Center shall notify the patient or applicant in writing within 30 days of receipt of a completed application.   Patients requesting financial assistance must complete the Confidential Financial Assistance income statements.

  3. If the determination has been made that the patient falls between 100% - 200% of the current Federal Poverty guidelines they will be eligible for the Financial Assistance Program.  Once eligibility is determined the Collections Manager will review and sign off.

  4. If the patient falls at or below 100% of the current Federal Poverty Level, a nominal fee of $5.00 will be collected. 

  5. Key criteria for determining eligibility for Financial Assistance are:

    1. Income between 100% and 200% of the federal poverty guidelines

    2. Family size

  6. The Chief Financial Officer will review the monthly Financial Assistance approvals and sign off.

 

B. Communication of the Discount Program to Patients and the Public 

 

Information about available Financial Assistance shall be made available which may include the following:  Notices posted at all points of patient check-in, information provided to the patient at time of registration, communication received from hospital business office or hospital based clinics.  Such information shall be provided in the primary languages spoken by the populations served by the site.  Referral of patient’s for financial assistance may be made by any member of Springhill Medical Center or its’ clinics including physicians, nurse practitioners, physician assistants, nurses, financial counselors, social workers, case managers, etc.  A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient subject to applicable privacy laws.

 

 C. Collection Policies

 

  1. All Clinics will attempt to obtain a financial assistance application and determine eligibility for all uninsured patients at or near the time of service. 

  2. Written notice will be mailed to the patient/guarantor for any incomplete application received.

  3. Make and document a determination of whether the patient is eligible for charity care for a patient who submits a complete charity application.

  4. Collection efforts will be made to determine a patient’s eligibility for charity care for a period of 120 days.   During this period patients will receive 4 statements.  After this period reasonable collection efforts will be considered to have been made and the patients account will be reviewed for collections placement and/or bad debt.

 

D. Policy Changes

This policy may be revised at any time as business needs require.

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