Patient Resources

Financial/Charity Policy

It is the policy of Erlanger Health System to grant our patients access to essential or non elective care, regardless of their ability to pay and their ethnic origin.

Charity Care or uncompensated care is available to all patients who wish to apply. Financial Counselors are available to assist our patients in making applications for charity care, which is available for those who earn up to 250% of Federal Poverty Guidelines. In addition to assisting with charity care, staff is available to patients in determining eligibility for programs such as TennCare or Medicaid. One of the functions of the Financial Counselors is to assist uninsured patients in determining a source of payment.

For those patients not eligible for financial assistance, it is the policy of the Health System to permit patients where eligible to make regular payments on a monthly basis. Erlanger does utilize external collection firms on debt collection as needed. When appropriate, legal assistance is utilized for the purposes of collecting from those who have the ability to pay.

It is the policy of Erlanger to:

Treat all patients equally – with dignity, respect and compassion
Serve the emergency health needs of everyone regardless of their ability to pay
Assist patients who cannot pay for part or all of the care they receive at Erlanger
Balance the needed financial assistance for some patients with broader fiscal responsibilities in order to keep the Health System viable financially
Respond promptly to patient’s questions regarding their bills and requests for financial assistance
Make information available to patients regarding our charity care policy
Have clear understanding of written policies to help patients determine if they are eligible for public or hospital-sponsored financial assistance programs
Have written policies of discounts available to patients who do not qualify under our charity policy
Ensure outside collection agencies follow hospital billing and collection guidelines

Procedure:

The intent of the Erlanger Health System Charity Policy is to establish a fair and equitable system for determining hospital charity. General guidelines are established, allowing for evaluation of unique financial circumstances.

A patient is determined eligible by income standards when the annual individual or family income does not exceed 250% of the Federal Poverty Guidelines as published annually in the Federal Register. Present income will be a measured in assessing hospital charity but will not be the sole determining factor. Among other elements to be considered are temporary factors such as short term layoff, unemployment, disability or other demonstrated hardship. An evaluation of available assets will be necessary to determine eligibility for charity. If assets exist to pay the debt, charity may be denied. Medical Indigency can be a qualifying factor in determining charity care or uncompensated care. Patients who have credit scores below 550 can be declared medically indigent by Director of Patient Financial Services or designee.

Applications for assistance are available at Erlanger Health System between 8:00 a.m. and 4:30 p.m. (Monday through Friday) or with the Collection Representatives in Patient Financial Services. Services eligible for Charity Care are medically necessary inpatient and outpatient services.

Program Guidelinees:

Charity care eligibility is evaluated on the basis of available assets as well as gross family income.
Charity applies only after all other resources have been exhausted.
A determination of the applicant’s eligibility is made promptly after completion of the application.
Income Guidelines: To be eligible for the program, gross family income must be at or below the following levels:
2008 HHS Poverty Guidelines
Size of Family Unit Income
1 person $10,400
2 people $14,000
3 people $17.600
4 people $21,200
5 people $24,800
6 people $28,400
7 people $32,000
8 people $35,600
For family units with more than 8 members, add $3,600 annually for each additional member (The same increment applies to smaller family sizes also, as seen in the figures above).

Assistance is available to applicants whose income exceeds 100% of the Federal Poverty Guidelines.

Income	Patient Responsibility
> 100% <150%	25% of charges
>150% <175%	50% of charges
>175% <200%	75% of charges
>200% <250%	The percentage under 75% but less than 100%

Catastrophic expenses fall under this Charity Policy if uncompensated charges exceed 50% of the total annual family income and or assets. A review of the patient’s financial condition will be performed to determine eligibility under this provision.
Amounts may be deemed as charity by external collection agencies and or attorneys upon cancellation of a debt back to Erlanger Health System.
Asset and credits investigations may be made on all charity adjustments greater than $1000.00. If it is determined that assets exist to pay the debt, charity may be disallowed.
Charity requests for $10,000 and above the most current Federal Tax Return and the most current bank statement are required. If the patient does not have one or both the following can be used for verification of income and/or assets.
- Pay check stub - Letter from employer - Statement of monthly benefits for social security
Three separate adjustment codes will be utilized to adjust a patient's account:
- Certified Hamilton County Charity Care (Adjustment code 219295)
- Erlanger Hamilton County Charity Care (Adjustment code 230896)
- Out of Area Charity Care (Adjustment code 230292)
Charity in cases that fall outside the established guidelines must be approved by the Director, Patient Financial Services or designee.

Uninsured, Self Pay Patients:

A Managed Care type discount of forty-one percent(41%) effective July 1, 2007 will be applied to all self pay accounts who do not qualify for a payment source. These discounts do not apply to programs or services which are deemed to be elective in nature. Examples of these include wellness programs, cosmetic procedures etc. These type programs have specific pricing and are exempt from receiving the discount.

Monthly Payment Arrangements:

Patients are permitted to make monthly payment arrangements for amounts owed. Efforts will be made by the hospital to collect balances in full either by cash, check or credit card, prior to establishing monthly payment arrangements. In lieu of payment arrangements, hospital reserves the right to refer eligible patients for bank loans to pay off hospital account. The hospital does not change interest on monthly payment plans, therefore long term arrangements are discouraged wherever possible. Typically, payment arrangements are limited to 2 years. See attached schedule of payments. The minimum monthly payment is dependent on the balance of the account. Approval by Director of PFS or designee is required if the payment is less than required by the payment schedule.

Use of outside agencies/attorneys:

When it is determined the patient has not responded to our request for payment, an account can be referred to an outside collection agency or attorney for collection assistance. At the time the account is assigned for collection, hospital reserves the right to assess a collection fee to the patients account.

Litigation:

When appropriate, hospital reserves the right to seek judgment for those patients who have refused to pay outstanding debt. Hospital will not cause action to have patient removed from their property,but where appropriate will seek judgment for amount owed.

Prior to pursuing litigation, the hospital will review the detailed financial condition of patient via credit reporting to ensure litigation is appropriate.

Credit Reporting:

Erlanger routinely utilizes data provided by external agencies to verify information as to credit score, assets, etc. This information is frequently used in assessing charity eligibility, determining medical indigency, and the viability of collection on the patients account.

PAYMENT SCHEDULE

$25.00 - $600.00	Minimum payment of $25.00 per month
$601.00-$1200.00	Minimum payment of $50.00 per month
$1201.00-$1800.00	Minimum payment of $75.00 per month
$1801.00-$2400.00	Minimum payment of $100.00 per month
$2401.00-$3000.00	Minimum payment of $125.00 per month
$3001.00-$3600.00	Minimum payment of $150.00 per month
$3601.00-$4200.00	Minimum payment of $175.00 per month
$4201.00-$4800.00	Minimum payment of $200.00 per month
$4801.00 & Above	Minimum payment of $225.00 per month

Approval must be obtained from the PFS Director or his designee to accept a payment plan that is less than what is described in the schedule.