Financial Assistance Policy
BONE AND JOINT SURGICAL SUITES, LLC recognizes that it has a responsibility to provide care to individuals who may not be in the financial position to pay for medical services. Guidelines have been established to assist in determining Financial Hardship (i.e. charity and indigent care) to individuals who are financially indigent or cannot comply with the surgery center’s financial policy due to extenuating circumstances which warrant consideration for charity care.
As a general rule, no employee or member of BONE AND JOINT SURGICAL SUITES, LLC shall offer a waiver of copayments or deductibles, to any physician, patient, or any other party to induce the referral to any health care business, patient or other item of service to BONE AND JOINT SURGICAL SUITES, LLC.
Notwithstanding the general rule, should a patient request financial hardship assistance, BONE AND JOINT SURGICAL SUITES, LLC will offer the patient the Financial Hardship Waiver form and attempt to collect the necessary documents to confirm the patient’s family income with respect to the Federal Poverty Income Guidelines. Financial adjustments shall be made only in documented cases that meet the eligibility criteria of financial hardship.
ELIGIBILITY
**All patients requesting a charity care need to complete the Financial Hardship Waiver Request and provide documentation of their income level(s).
These documents include one or more of the following:
- W-2 withholding statements;
- Pay stub(s) from last three months;
- Previous year federal and state income tax returns;
- Medicare and Medicaid information with regards to qualifications;
- Forms approving or denying unemployment compensation;
- Written statements from employers or welfare agencies;
- Other reasonable documentation as requested by BONEAND JOINT SURGICAL SUITES, LLC
BONE AND JOINT SURGICAL SUITES, LLC will keep all information relating to this request confidential except as needed to comply with a court order or other legal requirement. If we deny a request to waive copayments or deductibles and later receive additional documentation of financial hardship, we will reconsider the request based on the new documentation.
Uninsured patients (i.e., those patient without third party payer coverage for health care services) qualify for a financial adjustment:
- Indigent Care: Patient must be uninsured. Family income is less than or equal to 125% of the current Federal Poverty Guidelines and patient does not qualify for Medicaid or Medicare qualifies for a 100% charity adjustment, which means that their services are free.
- Charity Care: Patient must have financial hardship. These patients may have insurance but are underinsured or facility is out-of-network with their insurance. A family income greater than 125% of the current Federal Poverty Guidelines qualifies for a charity adjustment amount determined by physician or administrator approval.
All approvals for Financial Hardship requests will be by the Center Administrator. Charity & Indigent write-offs can occur before or after a procedure. Center will keep all information relating to Financial Hardship requests in confidence.
Collections
90 days past due prior to referring to collections. Patients will receive three statements and one phone call before being added to a collection list. For collections questions or concerns please call: 863-593-7207.
