Financial Policy
Policy #AD2.31
HENRY MEDICAL CENTER
Stockbridge, Georgia
Key Index Title: Indigent Care
Effective Date: January 2002
Distribution:Admissions, Patient Accounts, Fiscal Services and Administration
Supersedes: 7/1/92; 11/95
Formulated By: Fiscal Services; Administration
Policy:
The purpose of this indigent care policy is to provide care free of charge to those medically indigent patients whose income is below 125% of the Federal Poverty Guidelines as published each year in the Federal Register. The hospital will provide care at a reduced charge to those medically indigent patients whose income is greater than or equal to 125% but not greater than 200% of the Federal Poverty Guidelines.
Policy:
Care will be provided to all qualifying patients regardless of their ability to pay. This policy will extend to all types of services (inpatient, outpatient, and emergency room) provided at Henry Medical Center.
The indigent care policy of Henry Medical Center is to write-off 100% of charges for medically indigent patients who are below 125% of the Federal Poverty Guidelines. For uninsured patients whose income is not less than 125% but not greater than 200% of the Federal Poverty Guidelines, charges will be reduced according to the schedule below.
Henry Medical Center will make uncompensated services available to all qualifying patients for all types of services except those emergency room charges which cannot be documented as true or potential medical emergencies as defined by the Medicaid program. Persons are eligible for uncompensated services if they:
(1) are not covered or receive services not covered under a third-party insurer or governmental program; and
(2) have an annual family income of not more than 200% of the Federal Poverty Income Guidelines; and
(3) request services provided by the hospital.
Notices will be published in the local newspaper describing the hospital’s obligation under the Indigent Care Trust Fund. Signs will be posted conspicuously in the admission areas, business office, and emergency room. Individual notification will be distributed to all patients seeking services on behalf of himself or another. Admission representatives will explain the notices to the satisfaction of the patient.
The hospital will make a written determination of eligibility in response to each request for uncompensated services. A request for uncompensated services is an indication of an inability to pay. Documentation to substantiate requests should be provided as soon as possible after the admit date. The hospital will determine if the patient meets either category of medical indigency after receiving substantiation and report to the patient within 30 working days of receipt of the completed application.
Requests made after the date of service will also be considered for eligibility. Post service requests will be given a written determination no later than the end of the first full billing cycle following the request. Requests for patients who were not eligible at the time of services will be reconsidered for eligibility if there has been a change in the income within a 90 day period following the date for which services were rendered.
Procedure:
At the time of admission, each uninsured patient will be informed of the availability of assistance under the trust fund and be requested to complete the attached survey requiring income information. This survey will be used to determine the payment category of each uninsured patient. For each patient below the 200% threshold, the admission representative should ask the patient to bring documentation of their income to the hospital. Documentation will include copies of W-2s, pay stubs, tax returns, oral verification of wages from employers, or oral verification of income from state agencies. The survey and documentation will become property of the hospital and is to be kept confidential in the same manner as medical records. However, this information will be used in the aggregate (i.e. de-identified) for reporting purposes.
After a determination of program eligibility has been made, the patient’s portion of the payment liability will be determined. If the account is below 125% of the Federal Poverty Guidelines, the account will be adjusted to a zero balance and the patient sent a letter informing him/her of the status of care provided at Henry Medical Center. If the account is greater than or equal to 125% but not greater than 200% of the guidelines, the charges will be reduced by the percentages listed in the following table. The patient will be sent a letter informing him/her of his/her liability and payment plan options.
Reviewed / Revised: 10/95; 1/02; 11/29/02
President/CEO