Financial Assistance Policy

SMH Community Care Application (for reduced monthly payments)

Policy
It is the policy of Schoolcraft Memorial Hospital (SMH) to provide medically necessary services to all patients regardless of ability to pay.  The goal of the Business Office is to help all patients understand their medical bills and work with patients to set up the most fair and equitable payment plan for both the hospital and the patient.  SMH does not charge interest on any outstanding balances.

SMH offers the following financial services to assist patients with their bills:


Prompt Pay Discounts
A 10% prompt-pay discount will be given to all patients who pay their bill in full within 30 days of their first statement.  The statement will calculate the 10% discount and display the 90% due on the patient’s payment stub with the due date printed above it.


Uninsured Discounts
SMH will provide any uninsured patient an “uninsured discount” for medically necessary or emergency services.

The discount will be deducted and shown on the patient’s first statement.  Patients will be advised on their first statement to contact Patient Financial Services to set up a payment plan for the remaining balance.  Uninsured patients are eligible for the prompt-pay discount in addition to the uninsured discount.


Community Care
The Community Care Program is designed to help financially indigent patients by offering free or discounted care.  Below are the requirements for this program:


100% discount
1) Patients total household income must not exceed 200% of the National Federal Poverty Guidelines.
2) Patients must show a denial letter or an acceptance with a high spend down from Medical Assistance.
3) Patients must fill out and return a Community Care Application and submit all required documentation.
4) Total equity of all personalassets (excluding patient’s home and one primary vehicle) cannot be greater than $20,000.

Once approved, the patient will be covered for six months.  Procedures that are considered not medically necessary, experimental, or cosmetic by the government or third‐party payers are not eligible for Community Care discounts. Cardiac Rehab Phase III services are deemed an exception to this exclusion.


Medically Indigent
Patients will be considered medically indigent by SMH if the private pay portion of their medical bill exceeds 25% of their annual household income due to catastrophic costs or conditions for medically necessary or emergency services.  SMH will reduce their medical bill to equal 10% of their annual household income.

Patients will need to provide the following documentation to the Patient Financial Counselor to be considered for eligibility:

1)  A copy of their most recent federal income tax return
2)  A denial letter from Medical Assistance (in some circumstances this may be obtained through a phone call from DHS)
3)  A signed Affirmation of Financial Disclosure form presented to them during financial counseling.Elective or Schedule


Procedures
Patients will be required to meet with Patient Financial Services prior to all elective, non-covered services.  The financial counselor will give the patient an estimated cost of the service and a 25% down payment will be required at that time.  In addition, patients will be required to set up a payment plan with the counselor to pay for the remaining balance.Payment


Plans
SMH offers interest free payment plans to all patients.  The payment plans are shown below.

Hospital Bill Amount Standard Plan
Monthly Payment
Reduced Plan
Monthly Payment
  $0 – $1,500         $  50         $  25
$1,501 – $  3,000         $  75         $  50
$3,001 – $  5,000         $100         $  75
$5,001 – $  7,000         $150         $100
$7,001 – $10,000         $175         $125
>$10,000         $200         $150

Based on a patient’s current financial status obtained through financial counseling with the patient, the Patient Financial Counselor will determine which plan is appropriate for the patient.


Actions for Unpaid Accounts
SMH will work with patients to set up payment plans for the patient portion of their medical bill.  Hospital statements are sent out on a monthly cycle.  If a patient makes no payment after three statements, they will be notified with a letter to contact SMH to make payment arrangements.  If contact is not established and payment arrangements completed at this time, a final warning letter will be issued prior to placement of the account with a collection agency.  SMH will make every
effort throughout this process to contact the patient.


Billing and Collections Policy

It is the policy of Schoolcraft Memorial Hospital (SMH) to provide medically necessary services to all patients regardless of their ability to pay. SMH offers patients several payment options through its Patient Financial Assistance (PFA) policy #10 BO. SMH will make every effort to inform patients of its PFA policy and to determine eligibility for financial assistance as outlined in the PFA policy and billing and collection procedures below.

SMH cannot make a determination on a patient’s eligibility under its PFA policy unless all of the required paperwork is returned. If a patient qualifies for financial assistance, but does not return all of the paperwork to validate it, SMH must follow the same collection efforts as it does with other delinquent accounts.

If a patient does not respond to SMH by filling out financial assistance paperwork, setting up a payment plan, or making a payment, then the account will be sent to an external collection agency.

Once an account is placed with an outside collection agency, the collection agency must notify and get approval from SMH prior to taking legal action on any accounts. SMH will only permit the collection agency to pursue a court order to seek judgement that would allow garnishment of wages, State tax refunds, or bank accounts in accordance with Michigan law. SMH will not allow the collection agency to enter into any lawsuit that permits the arrest of a person, places a lien on a residence, or seizes property in order to collect a patient’s account

Procedures:

  1. SMH will give all uninsured patients a copy of its PFA policy #10 BO upon admission.
  2. SMH will encourage all uninsured, non-emergent patients to speak with the Patient Financial Service (PFS) counselor upon admission.
  3. A copy of the PFA policy will be available to all patients in a brochure located in all admission offices, hospital lobbies, and on the hospital website.
  4. Hospital statements will be sent out on a monthly basis. If the minimum payment is not made after three statements, a first collection letter will be mailed to the patient (see attachment Letter A). The PFS counselor will attempt to contact the patient to inform them of the forthcoming letter and of their payment options under the PFA policy.
  5. If payment is still not received within 30 days, a second and final notice letter will be sent (see attachment Letter B). Patients are informed in the second letter that their account will go to an outside collection agency if payment is not received within 10 days.
  6. Accounts where payment is not received after this final 10 day period will be listed on a report prepared by the PFS counselor and given to the Finance Committee and Board of Trustees to review at their monthly meeting. Accounts with a balance greater than $500.00 are individually listed (excluding patient names and account numbers). Accounts with a balance less than $500.00 are reported in aggregate. Those accounts with a balance greater than $5,000.00 are given footnoted detail.
  7. Once the total monthly bad debt amount is approved by the Board of Trustees at the monthly meeting, the PFS counselor will write off the bad debt balance within 3 days. The accounts are then placed with SMH’s collection agencies.

DOWNLOAD:

Schoolcraft Memorial Hospital – Financial Assistance Application


Financial Assistance Policy Plain Language Summary

Schoolcraft Memorial Hospital’s Financial Assistance Policy (FAP) exists to provide eligible patients, partially or fully-discounted emergency or other medically necessary healthcare services provided by Schoolcraft Memorial Hospital, its Rural Health Clinic (RHC), Homecare, hospice, or employed/contracted providers. Schoolcraft Memorial Hospital offers various discounts and an assistance program. Patients seeking assistance must apply for the program.

Eligible Services: In general, the FAP applies to emergency or medically necessary healthcare services provided and billed by Schoolcraft Memorial Hospital, its RHC, Homecare, hospice, or providers.

Eligible Patients: Patients receiving eligible services, who submit a complete Financial Assistance Application, which includes related documentation/information, and who are deemed eligible for financial assistance by Schoolcraft Memorial Hospital.

SMH offers the following financial assistance discounts/programs:

Prompt-Pay Discount

A 10% discount is applied to patients who pay account balances in full within the first 30 days of their first statement.

Uninsured Discounts

SMH will provide all uninsured patients a discount for emergency and other medically necessary charges in the amount of total patient charges less the respective Medicare inpatient or outpatient rate plus 15%. In addition, patients that receive the uninsured discount are also eligible for the prompt-pay discount.

Community Care Program

The Community Care Program is designed to help financially indigent patients by offering free or discounted care. Following are the requirements for this program:

100% discount  

1) Patients total household income must not exceed 200% of the National Federal Poverty Guidelines.

2) Patients must show a denial letter or an acceptance with a high spend down from Medical Assistance.

3) Patients must fill out and return a Community Care Application and submit all required documentation.

4) Total equity of all personal assets (excluding patient’s home and one primary vehicle) cannot be greater than $20,000.

Once approved, the patient will be covered for six months.  Procedures that are considered not medically necessary, experimental, or cosmetic by the government or thirdparty payers are not eligible for Community Care discounts. Cardiac Rehab Phase III services are deemed an exception to this exclusion as they are considered vital to the cardiac health of SMH patients and a deterrent against the need for more serious and costly cardiac services.  

Medically Indigent

Patients will be considered medically indigent by SMH if the private pay portion of their medical bill exceeds 25% of their annual household income due to catastrophic costs or conditions for medically necessary or emergency services.  SMH will reduce their medical bill to equal 10% of their annual household income.

Patients will need to provide the following documentation to the Patient Financial Counselor to be considered for eligibility:

  1. A copy of their most recent federal income tax return
  2. A denial letter from Medical Assistance (in some circumstances this may be obtained through a phone call from DHS)
  3. A signed Affirmation of Financial Disclosure form presented to them during financial counseling.

SMH uses revenue generated by the hospital’s 340b drug program to help fund the Community Care and Medically Indigent programs.

How to Apply: The FAP and related Application Form may be obtained/completed/submitted as follows:

  • At Schoolcraft Memorial Hospital’s main Registration desk, RHC registration desk, or Emergency Room desk;
  • Request documents be mailed to you, by calling Schoolcraft Memorial Hospital’s Patient Financial Services representative at (906) 341-3230;
  • Request documents in person at Schoolcraft Memorial Hospital at 7870 W US Hwy, 2, Manistique, MI 49854;
  • Download the documents from Schoolcraft Memorial Hospital’s website www.scmh.org/patientvisitor-info/financial-assistance-policy/;
  • Mail completed Applications (with all required documentation/information specified in the application instructions) to the address listed above;
  • Reserve an appointment with a Patient Financial Services Representative to receive assistance completing the Application, by calling (906)-341-3230.

Schoolcraft Memorial Hospital also translates its Financial Assistance Policy, Community Cares Application and this Plain Language Summary of its Financial Assistance Policy in other languages when the primary language of the residents of the community served by Schoolcraft Memorial Hospital is either a minimum of 5% or 400 individuals within the population likely to be affected or have an encounter with Schoolcraft Memorial Hospital. Translated versions are available upon request in person, at the address listed above, by mail, and on Schoolcraft Memorial Hospital’s website.

For assistance or questions please visit Schoolcraft Memorial Hospital registration, RHC registration or Emergency Room desk at the address listed above, Monday through Friday 8:00 am to 6:00 pm, and Saturday 8:00 to Noon. A Patient Financial Services Representative can also be reached by phone at (906) 341-3230.

DOWNLOAD:

Schoolcraft Memorial Hospital – Financial Assistance Application

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