Community Medical Center Financial Assistance Guidelines: Community Medical Center is a non-profit hospital offering a broad range of services, which are provided with efficiency and sensitivity to the patient’s needs, both medically and financially. CMC will identify candidate for financial assistance based upon financial needs, using criteria established by policy. It is our policy to offer financial assistance to person in need as early as we can reasonably identify those persons, as provided in the policy, with due regards to each person’s financial privacy. Financial assistance is available without regard to race, color, creed, national origin, age disability, health care condition or marital status.
Statement of Principles and Guidelines:
Community Medical Center will:
- Treat all patients equitable, with dignity, with respect and compassion
- Serve the emergency health care needs of everyone, regardless of a patient’s ability to pay for care
- Assist patients who cannot pay for part or all of the care they receive
- Balance needed financial assistance for some patients with broader fiscal responsibilities in order to keep or hospital’s doors open for all who may need care in our community
The following criteria will be used to determine eligibility:
- Patient care, which is not medically necessary, including elective, cosmetic, or other care deemed to be generally not reimbursable by traditional insurance carriers and governmental payers, shall not be considered eligible for financial assistance.
- Minor children/divorced parents- both parents/legal guardians are responsible parties, for information regarding both parents will be required to complete the application for financial assistance.
- Financial assistance provided by CMC under this policy is secondary to all other third parties and financial resources available to the patient. If needed, assistance is available to help facilitate application for other sources of payment (Medicaid, Crime Victims, SSI, SSDI, etc.)
- Federal Poverty guidelines will be utilized to determine financial eligibility for assistance. These amounts will be updated annually as published in the Federal Register.
- The financial guidelines include assistance for individuals below 200% of the FPL and a sliding scale for individuals falling below 300% but greater than 200%. Assets in excess of $7500 may be factored in when determining the level of financial assistance to be applied.
The opportunity for Financial Assistance adjustments will be communicated to patients through the following methods:
- Pre-Service – During the pre-registration process for scheduled inpatients and high-dollar outpatient cases, the centralized pre-registration staff will communicate the policy to patients and attempt to have the patient complete the Financial Assistance application forms prior to service.
- Point-of-Service – At the time of service, self pay patients will be informed of the opportunity to seek Financial Assistance adjustments and will be offered the application forms. Financial counselors are available to assist patients in completing the forms.
- Post-Service – A message is printed on patient billing statements to notify self pay patients that Financial Assistance is available. Additionally, Patient Accounts personnel will notify self pay patients of the Financial Assistance program through the customer service and collection departments.
Requirements
The following proof of income must be included with the Financial Assistance Application:
- Payroll check stubs, or other monthly income sources for the last three months for all persons living in the household.
- Notice of ineligibility from Medicaid, state medical Crime Victims, etc.
- Copy of latest Federal Income Tax Return, with supporting schedules.
Annual income will be calculated using income documents. This is the gross annual income. Total income of the last 3 months pay stubs will be multiplied x 4 to arrive at a yearly income. The patient’s financial status will be evaluated using the Patient Assistance Eligibility Guidelines table. Patients who have incurred large medical expenses in relation to their financial means could be eligible for additional reductions of their calculated liability; this will be done on an individual basis. If CMC determines that any material documentation or information submitted is untrue or falsified, the application will be denied. Payment arrangements will be made for the adjusted patient liability when applicable according to the established credit policy. The President of Community Medical Center can make exceptions to this policy.