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Charity Care
Charity Care Policy
La Póliza de Cuidado Caritativo
Application Instructions
Instrucciones de Solicitar
Charity Care Application
Aplicacìon para Cuidado Caritativo
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Charity Care Policy
It is the policy of Winthrop University Hospital to inform every patient of the availability of charity
care (financial assistance), defined as free or reduced healthcare services to the poor or indigent
based upon their ability to pay and lack of insurance coverage. This policy will be uniformly applied
to all patients who request such consideration based on financial need.
Uninsured patients who present for services will be referred to Winthrop's Credit and Collection department for financial screening. A charity care determination will be made generally within three weeks following the receipt of a completed application, assuming all requested documentation has been provided by the patient (see below).
Patients who call or write for assistance with their hospital bill will be directed to the Credit and Collection department. Determination can be made either before, during, or after the episode of care.
The patient and/or family will be screened for potential Medicaid, Child Health Plus, Family Health Plus, CHCEP. If the patient/family is deemed eligible for any of the above, the patient will also be provided an application for Charity Care. If insurance is ultimately obtained, the patient / family member will not be eligible for charity care. Patients who are deemed by the Hospital to be eligible for Medicaid will be classified as "Medicaid Pending" and will receive "adjusted bills" that have been reduced from a "charge" level to an "expected net reimbursement" level.
In order to determine Charity Care, the patient/family will need to return an application, completed and signed, with the following documents within 110 days of the date of service or discharge (Winthrop reserves the right to extend this period on a case-by-case basis):
- If employed, three months worth of consecutive pay stubs
- Unemployment checks/compensation papers/Social Security checks.
- Most recent income tax return, including W-2s, for the past 2 years.
- A completed Charity Care Request Form
- Other documentation as requested
Generally, the patient's family income must not exceed 300 percent of the Federal Poverty level to qualify. Additionally, reviews of the requested documents must provide indication that no other sources of income are available (for information on the Federal Poverty Guidelines go to http://aspe.hhs.gov/poverty/).
The Credit and Collection Department will conduct a personal interview with the patient and make an initial determination as to whether the patient qualifies for charity care after the interview has been completed and at least one of the required documents is submitted. Once a determination that the patient may qualify for charity care is made, an initial charity care reduction is applied to the patient's bill. This reduction results in an "adjusted bill" to the patient that represents a recapture of the Hospital's costs. The patient is notified that this represents a minimum amount of charity care available, but all documents and forms must be provided to qualify. Additional charity care can be provided upon submission of all required documentation. The patient is also notified that no payments are required until eligibility has been determined by Winthrop.
Upon receipt of all requested documentation the Credit and Collection department will make a final determination as to the patient's Charity Care status within three weeks. If all requested documentation is not received the patient will not qualify. If a favorable determination is made the Credit and Collection Department may apply a second phase of charity care reduction to the patient's adjusted bill. This reduction will be a sliding scale reduction based on family size and income levels. The scale will be based on a 100 percent write off at household income levels under 200 percent of the most recently published Federal Poverty Level (FPL), a 75% write off on incomes over 200% and up to 233% of the FPL, a 50% write off on incomes over 233% and under 266% of FPL, and a 25% write off for household incomes over 266% and under 300% of FPL. Additionally, the patient's ultimate responsibility can be paid, interest free, to Winthrop. Installment payments will not exceed 24 months without Administrative approval or unless each monthly payment amount exceeds 10 percent of the patient's monthly family income. In such cases, the monthly installment would be capped at 10% of the monthly family income.
Patients who are underinsured or do not meet the criteria to qualify for financial assistance as noted above may be considered for assistance on a case-by-case basis. The extent of such assistance will be determined by the Hospital.
A patient may appeal the Hospital's decision regarding the disapproval or level of approved charity care. Appeals are to be directed to the Director of Patient Accounts for review. A final decision will be made within 2 weeks of the request.
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