FINANCIAL ASSISTANCE, UNINSURED, AND INDIGENT POLICY

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Policy:

Hardin Medical Center (HMC) is committed to treating all patients equitably, with  dignity, respect and compassion. HMC provides services in anticipation of payment  by the patient and/or guarantor for those services rendered. HMC determines  eligibility for financial assistance and assists patients in qualifying for available payment  sources. HMC offers patients who qualify for financial assistance, a reasonable variety  of payment options or terms for payment, including partial payment.  HMC will provide a  self-pay discount in compliance with Tennessee Code Annotated (TCA)-68-11-262. The  discount percentages will be evaluated on an annual basis and be adjusted as necessary. This  uninsured discount will be applied based on total charges before any other discounts for  which the patient qualifies.

Procedure(s):

The benefits offered by this policy is dependent upon the patient providing requested information necessary for determining eligibility. Failure of the patient to provide requested information in a timely manner will result in the application of standard collection processes.

I. Identify whether uninsured or medically underinsured patient is able or partially able to pay for services, utilizing a sliding scale to determine patient’s ability to pay based on % of current year HHS Poverty Guidelines.

% of Poverty Level	Insured Patients	Uninsured Patients
0-99%	100% Indigent Care	100% Indigent Care
100-119%	100% Indigent Care	100% Indigent Care
120-139%	Balances >$100.00 Patient will be required to pay an amount set by the organization and the remaining balance will be adjusted to charity.	100% Indigent Care
140-169%	25% Financial Assistance Discount	Self-Pay Discount Only
170-199%	None	Self-Pay Discount Only
200- and over	None	Self-Pay Discount Only

II. Identify whether the uninsured or medically underinsured patient with income in excess of 200% and less than 400% of the poverty guidelines is eligible for a discount.

If the  patient’s gross income is greater than 200% but less than  400% of the poverty guideline and their out of pocket liability in a single encounter exceeds $5,000, they are eligible for a 25% discount on their out of pocket liability.

III. Identify whether the uninsured or medically underinsured patient is eligible for payment arrangements.

>$100	Paid in Full
>$250	90 days
$251-$750	6 months
>$751	6 months or Needs to be evaluated to see if eligible for Financial Assistance

IV.  All self-pay non-financial assistance/indigent patients are eligible for 10% prompt pay discount; if balance is paid in full which in 30 days of first statement and balance due is more than $100.00

V. All self-pay patients are required to pay up front or after care deposits for services rendered regardless of their charity status.

VI. Additional discounts must be approved by the CEO and CFO.

VII. The uninsured or medically underinsured patients may be approved for charity/indigent care if the total owed to the hospital is more than $100.00.  However, if balance is less than $100.00 balance is to be paid in full.

VIII. HMC Physician Service accounts will follow the same hospital guideline for charity/indigent care discounts.