PATIENT FINANCIAL SERVICES

POLICY: Our business office staff is committed to providing service and expertise that is clear, correct, concise and patient friendly. Our patient financial billers are highly skilled and prepared to serve the patient in an atmosphere of professional friendliness.

FINANCIAL ARRANGEMENT OPTIONS

Each time a patient receives services at Hayward Area Memorial Hospital, a separate account is created. If the patient is receiving monthly ongoing services, a monthly account is created. It is possible to have several accounts open at the same time, for which the debtor will receive separate statements. Statements may reflect accounts billed to health plans that are not yet resolved, or balances that the debtor may owe. Hayward Area Memorial Hospital accepts cash, check, money order, or credit card (MasterCard or Visa). Hayward Area Memorial Hospital provides insurance billing and follow-up services for patients who assign third party benefits to the hospital. After the insurance carrier has processed the claim, or if the patient does not have insurance, the remaining balance becomes classified as “self pay.” To assist the debtor in financing this balance, the following options are available:

•Balance of account to be paid in full in thirty (30) days.

 •Interest Free Financing - Special arrangements can be made through the Business Office. The debtor will be required to make minimum monthly payments of 10% of the initial self-pay balance or $25 until the account is paid in full with a minimum of $25.

•Community Care Program (Financial Aid) will be offered to those persons unable to pay for hospital services due to lack of financial resources. Program eligibility will be determined if the debtor’s household income and assets are equal to or less than 150% of the Federal Poverty Guidelines. Application to the program is a prerequisite and is made available to the patient at any time, either before or after services are rendered.

FINANCIAL COUNSELING

All patient financial billers will be trained about financial aid availability and how to communicate that to patients. Communication of the availability of financial aid and/or counseling will be made available in several venues:

•In person Monday through Friday at the hospital front desk located in the lobby of the hospital from 7:00 AM to 5:00 PM.

•Monthly statements inform debtor to call the Business Office if counseling is needed or the debtor has questions.

•At bedside for those inpatients who need assistance.

•On the Hayward Area Memorial Hospital website, billing policy and financial counseling information under the marker “Important Customer Information.”

•Legal notice published yearly in community newspaper of Community Care Program availability.

•Provide financial information statement to patients at Registration.

COMMUNITY SERVICE ASSURANCE

INCOME DETERMINATION/VERIFICATION PROCEDURES

Procedure to determine a patient’s ability to pay for health care services   

The Hayward Area Memorial Hospital in Hayward, Wisconsin, will comply with the requirement of Community Service Assurance under the Title VI of the PHS Act by making services available to persons residing in the service area without discrimination on the basis of race, color, national origin, creed or any other ground unrelated to the individual's need for the service or the availability of the needed service in the facility.

Community Care is designed to help patients who are unable to pay for health care services and are currently not covered by any insurance or government program. This program covers acute inpatient and outpatient service.

Patient eligibility for community care is determined by measuring family income against the current poverty guidelines and established by the Department of Health & Human Services. Income refers to total income from all sources before taxes or deductions.

Determinations are made within two working days following the date of the request for charity services based upon information supplied by the patient.

1. Total income for the last 3 months x 4 = Total income or

2. Total income for the last 12 months or the lessor of the above.

Procedure to verify financial information provided by the patient

Any of the following information/documentation should be provided by the applicant to substantiate financial information provided in the application:

1. Copies of payroll checks or check stubs reflecting year to date gross wages.

2. Copies of social security checks.

3. Copies of income tax reports.

 4. Copies of W-2's.

 Any of the above may substantiate financial information.

Notices

Notices of availability of community care will be given to all patients inquiring about community reduced payment care.

BILLING PROCEDURES

Self Pay

All patients in the self pay category will be given the opportunity to apply for uncompensated care at the time of admission and again if they have not applied when the billing is mailed.

COMMUNITY CARE APPLICATION

Insurance 

All patients in the insurance category (Insurance, Medicaid and Medicare) will be given the opportunity to apply for uncompensated care at the time of admission and again (if they have not applied) after their pay source has paid and if there is a balance on the bill. The exception to this is for those patients who have indicated they are not requesting free care and have made payment plans for their balances.

FINAL COLLECTION ACCOUNTS

Patients in the final collection category (Collection Agency) may be given the opportunity to apply for Community Care rather than their account going to an agency for collection.

The above procedures will be in effect during the entire year of April 1, 2003 through March 31, 2004 and the current fiscal year.