Reduced Payments
We are committed to providing you access to healthcare and to reducing the cost of care. If you qualify for reduced payment, this policy tells you about how you can receive reduced fees. We help patients who cannot afford, but need healthcare. We also help patients who do not qualify for public programs. If you cannot afford to pay for your services right away, we can help you arrange a payment plan.
How does this work?
Medical Financial Assistance: You need to let the hospital know that you may need some help with your payment. Next we will ask you to fill out a form. It is important that you return this form to the business office as soon as you complete it. Important papers that help us determine your eligibility will be requested including:
- Proof of insurance
- Proof of your assets (for example, your home and titles on any car you have)
- Income tax returns
- Bank statements
- Pay stubs
We can only consider your request for medical financial assistance once we have all of the information.
Eligibility: You qualify for reduced payments if you are BELOW 400% of the current Federal Poverty Level (FPL). The payment owed depends on your income. As of July 2005, an individual below 200% of the FPL would need to make less than $19,500, and a family of four would need to make less than $38,700 to qualify.
If you are below these numbers, you will be considered for a co-payment program:
| Your Income | Your payment would be |
Less than 100% of FPL |
$200 |
| 101% to 125% of FPL | $250 |
| 126% to 150% of FPL | $300 |
| 151% to 175% of FPL | $350 |
| 176% to 200% of FPL | $400 |
For households earning between 201% and 400% of the FPL
Households with an income between 201% and 400% of the FPL will be considered for a reduced payment as follows:
To be considered for reduced payments, a patient must be above the 200% ranges, but below the following income:
400%
For each person - $38,280
For a family of four - $77,400
Note: State law requires a 30% discount for those who have no insurance, however in some cases your discount may be higher than 30%. See our financial counselor for more information.
Household determination: Your household (including all legal dependents) is determined by your latest filed tax return.
Approval: A review committee meets monthly to determine eligibility. The review committee will make the final determination based on this policy.
- You will be notified within 10 days after final determination.
- Patients who die without an estate will have no income under this policy.
- We keep our records for 7 years.
Denials: If your application is not approved, you will be notified within 10 working days. We will tell you the reasons for our decision and the process for reconsideration.
Reconsideration: New or revised information must be submitted to the hospital within 15 days of the denial notice mail date.
* It is acknowledged that EMTALA regulations apply in all instances. Updated information on the Federal Poverty Level can be obtained at: http://www.aspe.hhs.gov/poverty/figures-fed-reg.shtml.
Please call our business office to discuss your options and payment arrangements.