Purpose: The Charity Care Policy provides guidelines and procedures to be followed in determining charity care. The policy will enable Administration to differentiate between the unwillingness of the patient to pay (Bad Debt) and the demonstrated inability of the patient to pay (Charity Care).
Policy: Madison Healthcare Services, hereinafter referred to as “Facility”, is committed to identifying charity care accounts during preadmission, admission, discharge and following discharge. Patients who meet the criteria for charity care will be eligible for a discount, in accordance with this policy, for all or part of a bill that a patient is normally expected to pay. Collection efforts, including the use of outside collection agencies, do not preclude eligibility for a charity care discount.
- The patient must have residence in the Facility’s primary service area – within a 50 mile radius of Madison.
- Request made that the patient apply for Medical Assistance or alternate source of coverage through existing public programs, but failure to apply will not disqualify them from Charity Care.
- The patient may be denied charity care discount if they declined insurance coverage under an employer sponsored plan.
- The patient or guarantor should, if at all possible, complete the Facility charity care application and return the completed application within thirty (30) days of receipt. An extension may be granted if requested.
- The patient has expired leaving no estate.
- Not all accounts have to be sent to collection agency to be eligible. If the facility has placed the account with a collection agency and the agency has determined that the account cannot be collected, they are eligible for charity care.
- The patient’s family income falls in the Poverty level guidelines and/or family net assets are less than $10,000.
- The patient has been on Medical Assistance or similar source of coverage within the past 12 months and has no change in employment or income status. If the patient is now on Medical Assistance or similar source of coverage and has past due accounts, the past due accounts may be considered for charity care.
- The patient has filed and been approved for bankruptcy.
- Charity Care discounts apply only to services provided at this Facility.
- Once a patient completes a charity care application it will be good for 1 year, at which time the individual will need to re-apply thru the charity care process if they so chose.
- If the patient is eligible for Medical Assistance or similar source of coverage, but Medical Assistance or other source will not pay for services in the facility (swing bed, etc), the patient qualifies for charity care.
- If the application is not returned or returned not completed in full – other patient markers can be used to approve for charity care – example WIC, food stamps, free lunches, MA spend down, low income housing, etc
- Patients who meet presumptive eligibility criteria may be granted financial assistance without completing an application.
- After any of the criteria are met to qualify, the percentages included with this policy will be used to determine the amount of discount applied to the outstanding balance.
- The CFO will have the authority to approve or deny charity care assistance.
- When an application for charity care is approved:
- The Patient Account Manager will “write off” the discounted amount as charity care.
- A letter will be sent to the patient or estate notifying them that their application was approved, the amount discounted and the remaining balance due from patient if any.
- Charity Care information will be kept on file for year end audit, cost report and surveys.
- When application for charity care is denied:
- A denial letter will be sent to the patient.
- Regular collection efforts will resume.
Charity Services Policy It is the policy of Madison Healthcare Services (MHS), consistent with our mission and values, to provide services to all persons, regardless of age, sex, race, religion, origin or ability to pay. Upon completion of charity care application, and verifying an inability to pay. MHS will provide financial assistance to qualifying patients to relieve them of their financial obligation in whole or part for health care services provided by Madison Healthcare Services. An inability to pay may be identified at any time. Based on poverty guidelines the following percentages will be discounted from the patient’s bill: If the patient falls in the 0 to 100 % of Poverty Level – a 100% discount will be applied If the patient falls in the 100 to 140% of Poverty Level – a 75% discount will be applied If the patient falls in the 140 to 200% of Poverty Level – a 50% discount will be applied If the patient falls in the 200 to 275% of Poverty Level – a 25% discount will be applied