|
All SSMHC facilities will strive to provide exceptional health-care services to persons in need regardless of their ability to pay. All billing and collection policies and practices will reflect the mission and values of SSMHC, including our special concern for people who are materially poor and vulnerable. SSMHC will apply its charity care policies fairly and consistently. Each person is treated as an individual with specific needs for assistance, without regard to payment. SSMHC embraces its responsibility to serve the communities in which we participate by establishing sound business practices.
SSM Health Care facilities offer discounts for hospital services to all uninsured persons. Discounted rates vary among regions. For instance, a hospital in an urban area may offer a discount of 40 percent because of competitive conditions, while hospitals in rural areas may offer discounts of 10 percent to 20 percent, because of the hospital charge structure and limited managed care activity there.
Self-pay discounts apply to everyone who does not have health insurance, no matter their ability to pay. The discounts apply to medically necessary hospital services, unless a special discount rate already applies to that service.
Applications for financial assistance are available in the admitting and registration areas and from the central business office. Eligibility is determined by the hospital or network business office within 14 days of receipt of a complete application.
Additionally:
- Patients are responsible for supplying supporting documentation to validate their financial information.
- Sometimes partial financial assistance results in a residual amount due which patients can pay through monthly installments.
- No payment plan will exceed six years.
Collection Practices
We have prohibited certain collection practices, including body attachments, excessive phone calls and letters, foreclosures on principal residences, and actions that force bankruptcy.
Charity Care Formula
Under our formula for charity care, the sliding scale runs from a 100 percent discount for individuals/families at twice the poverty level, to 80 percent for 2.5 times the poverty level, to 60 percent for 3 times the poverty level, to 40 percent for 3.5 times the poverty level, and 20 percent for 4 times the poverty level. This formula is based on income and number of family members. Even an individual who has health insurance could qualify for a charity discount on a co-pay, deductible or coinsurance. For uninsured patients, the charity discount is taken after the discount for uninsured patients has been applied.
Exception for Catastrophic Costs
Our policy includes an exception for catastrophic medical costs. A catastrophic cost is defined as a balance due that could not reasonably be paid through an installment plan for four years, or could not reasonably be paid given the family income and expenses.
Notification
Patients are notified of an eligibility decision within 14 days from receipt of the patient’s completed application for financial assistance. The patient needs to fill out only one application for all unpaid accounts. Completed applications are valid for three months from the date of eligibility.
Patients are informed of our charity care policy on signs in emergency rooms and registration areas and through conversations with hospital financial counselors and business office personnel. In addition, brochures and patient bills include information about financial assistance and discounted care. We have printed these brochures in several languages. |