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Charity Care Policy

OUACHITA COUNTY MEDICAL CENTER

OCMC is committed to ensuring access to high quality medical care to all members of our community. OCMC will provide necessary medical care to all acutely ill persons regardless of insurance status or ability to pay.

The need for charity care may be a sensitive and deeply personal issue for recipients. Confidentiality of information and preservation of individual dignity will be maintained for all who seek charitable services. No information obtained in the patient's charity care application may be released without the patient's permission, except to bona fide governmental agencies requesting aggregate data.

All patients will be made aware of the existence of this Charity Care Policy. Employees in the scheduling, patient access, patient financial services and emergency departments will be fully versed in the Charity Care Policy, have access to the charity care application forms, and be able to direct questions to the appropriate OCMC representatives.

Notices of this Charity Care Policy will be posted on the OCMC Website and in several prominent locations within the Hospital including, but not limited to, the emergency department, billing office, and registration areas. The notices will be clearly visible to the public.

Patients will be provided with information about this Charity Care Policy upon request, including specific information as to how eligibility is determined and the means of applying for assistance.

Charity care may be granted prospectively or retrospectively. All persons applying for or receiving charity care shall be treated with dignity and respect. All overdue accounts will be reviewed internally to determine whether the patient is eligible for financial assistance prior to initiation of any external collection efforts, legal proceedings, or other extraordinary collection efforts.

In the event a patient approved for financial assistance fails to comply with payment terms for a period of more than sixty (60) days, the account may be turned over to a collection agency or reported to a credit agency. Any collection agencies used by the Hospital will agree to refrain from abusive collection practices. Bench warrants and property foreclosures will not be part of collection efforts.

Eligibility:

1.         Eligibility for financial assistance and/or charity care will be determined by evaluating a variety of factors, including, but not limited to:

a.       Individual or family income
b.      Individual or family net worth
c.       Employment status and earning capacity
d.      Family size
e.       Amount and frequency of bills for healthcare services
f.        Other sources of payment for the services rendered
g.       Other financial obligations          

2.         A sliding scale, based on the Federal Poverty Guidelines, will be used as a guide to help determine the amount of financial assistance for which a patient qualifies; provided, however, that annual household income shall not be the only factor considered when determining eligibility for financial assistance. The 2014 Federal Poverty Guidelines are attached to this policy as Exhibit A.

3.         For patients who owe an extraordinary balance that is catastrophic to the family income base, catastrophic protection may be provided by limiting payment liability to zero (0) percent of annual household income. Determinations to provide catastrophic financial assistance will be made by the Chief Financial Officer.

4.         Patients who qualify for financial assistance will not be charged for emergency or other medically necessary care at rates higher than the "amounts generally billed" to third-party payers. The use of gross charges to such patients is prohibited. For purposes of this policy, "amounts generally billed" will be determined by averaging the rates charged to the hospital's three best commercial payers. This provision will be amended as necessary to comply with ACA upon promulgation of final regulations

5.         This Charity Care Policy applies only to Hospital charges and does not include physician or professional charges that are not billed by the Hospital. Charity care is limited to medically necessary services and is not available for elective procedures.

Procedure:

1.         Patients requesting financial assistance will be provided with an application for charity care. Application materials will include a notice to patients that upon submission of a completed application, including any information or documentation needed to determine eligibility, the patient may disregard any bills from the Hospital until OCMC has rendered a decision on the application.

2.         Completed charity care applications with supporting documentation should be returned to the Financial Counselor for review. Applications for inpatient services should be accompanied with a Medicaid denial. Renewal applications for outpatient recurring services should also be accompanied with a Medicaid denial.

3.         Patients who do not provide the requested information necessary to completely and accurately assess their financial situation in a timely manner and/or who do not cooperate with efforts to secure governmental healthcare coverage may not be eligible for charity care.

4.         This policy will be applied equally to all patients regardless of payer. Applications that do not meet established criteria may be approved based upon extraordinary circumstances with the documented approval of the Chief Financial Officer.

5.         Applications for charity care will be reviewed within thirty (30) days of receipt of a completed application. Patients will be notified of the Hospital's eligibility determination in a timely manner.

6.         If a patient has applied for and received charity care within the past twelve (12) months, and the patient's financial circumstances have not changed, the patient will be deemed eligible for charity care without having to submit a new charity care application.

7.         All applications for charity care will be maintained for a period of one (1) year.

This policy will be reviewed annually to determine appropriateness to current community and financial conditions. Policy revisions must be approved by the OCMC Board of Directors. Compliance will be monitored through periodic audits. Reports of such audits will be furnished to the Board of Directors.