Medical Financial Assistance Policy

Statement of Policy

In keeping with their tax-exempt  mission and community orientation, Bronson Methodist, Bronson LakeView and Bronson Battle Creek each acknowledge that all individuals are not equally capable of paying for healthcare services, either by themselves or through a third party insurance carrier. Bronson Methodist Hospital, Bronson LakeView Hospital Bronson Battle Creek Hospital each recognize their responsibility to offer care for persons in need, and therefore each hospital  provides and promotes access to emergency or medically necessary services without regard to ability to pay. (BHG Board – approved Charitable, Community Benefit and Corporate Citizen’s Policies 9/15/89.)

This Medical Financial Assistance Policy (“Policy”) has been developed to ensure that financial assistance for emergency or medically necessary services is provided to eligible individuals. Regardless of eligibility determination, confidentiality of the information submitted and individual dignity will be maintained for all that seek financial assistance.

Patients may request an application to determine if they qualify for financial assistance by calling a patient financial counselor at (269) 341-6120.

Procedure

Patients who can demonstrate that the payment of their hospital bill would be an unbearable hardship may apply for medical financial assistance pursuant to this Policy. This applies to all services that are billed under the Federal Tax I.D. numbers for Bronson Methodist, Bronson LakeView and Bronson Battle Creek. Referrals for medical financial assistance may originate from any member of the medical staff, Patient Relations, Pastoral Care, Medical Social Work, Employee in Crisis Committee or other hospital employees.

Patients are not eligible to apply for medical financial assistance in the following situations:

  • The patient was injured as a direct result of an accident involving his/her motor vehicle and the patient did not maintain the required insurance on the motor vehicle.
  • The balance is less than $ 100.00.
  • Patient did not enroll in Medicare Part B when he/she became eligible for benefits. The exception to this is if the patient was incarcerated when he/she became eligible for benefits. Medicare will not cover incarcerated beneficiaries.
  • The patient was injured committing an illegal act, crime or fleeing the police.
  • The patient was operating a motor vehicle (automobile, truck, ATV, motorcycle, moped, etc.) after drinking alcohol (regardless of blood level reading) or after taking any illegal drug/substance.
  • The patient has health insurance, but fails to follow the insurance company’s rules for pre-certification or seeks treatment at a Bronson facility when Bronson is not the preferred provider for that plan unless it is for a bona fide emergency.
  • Patient’s that are in the country illegally.
  • The following injuries or conditions are not eligible for financial assistance:
    • Cosmetic surgery or procedures including bariatric surgery
    • All other non-essential procedures.

Financial assistance may be pre-authorized for hardship cases with the approval of the Director of Patient Accounting.

The amount of financial assistance (total or partial) will be determined by the following process:

  • Patients that meet the Federal Poverty Income Guidelines will be presumed to be eligible for medical financial assistance.
  • All other patients first will be scored through Self Pay Compass to determine if they are eligible for financial assistance. If Compass cannot score the account, the patient must complete an Application for Eligibility Determination (“the Application’).
  • Patient completes the Application for Eligibility Determination for financial assistance and submits it along with the necessary documentation to the Patient Accounting Department for approval. NOTE:  Failure by the patient to fulfill all requirements of the application process will result in automatic denial.
  • Patients that are homeless are presumed to be eligible for medical financial assistance.
  • Once a patient is determined to be eligible for financial assistance, the patient/family must also meet the following criteria:
    • The patient must be screened for any other financial assistance (Medicare, Medicaid, Michigan Crippled Children, etc.) and determined ineligible.
    • The patient’s net household income must not exceed 300% of the poverty guidelines as provided by the Department of Health & Human Services for Region V.
    • A special exception can be made for any patient that is over the allowed income level but has catastrophic medical expenses over $ 10,000.00 from the applicable hospital. The catastrophic approval applies only to the patient; it does not apply to family members living in the same household.
    • Health insurance premiums, out of pocket expense for prescription drugs, child support paid to the Friend of the Court or alimony payments will be deducted from the monthly income. Receipts or check stubs are required to prove the amount to be deducted.

The Manager of Patient Financial Services will review the Application. Additional information to confirm income or assets may be requested before the Application is approved or denied.

In the event that assets or a payment become available, Bronson Hospital reserves the right to reverse the original adjustment.