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Payment Expectations and Discounts

This policy is effective for hospital discharge dates on or after January 1, 2008. This policy is applicable for all patients, and can be used in conjunction with our Financial Assistance policy.

John C. Lincoln Health Network is committed to providing the best care possible for all of our patients. Hospital representatives make every effort to identify patients in need of free or discounted health care, both at the time of service and through our normal collection process.

Policy

Payment Expectations

Except as otherwise provided by law, the patient or responsible party is financially responsible for services provided by John C Lincoln Health Network and agrees to pay the hospital’s charges which are those rates filed with the Arizona Department of Health Services. The hospital may verify the patient’s address and ability to pay by utilizing credit reporting data.

• If patient does not have health insurance, we will expect the patient or responsible party to pay the discounted estimated charges at the time patient is admitted or registered.
• For emergency services, a deposit is expected after the medical screening exam is completed.
• If patient has insurance, deductibles and co-payments will be collected at time of service, and the patient/guarantor is responsible for any non-covered services.
• If patient's insurance company has not paid John C. Lincoln within 60 days of the time we bill the company, we will expect payment from the patient. Formal payment arrangements can be set up to extend the payment time frame, within the hospital’s policy.
• If patient's account is referred to an independent agency for collection, the patient/guarantor will be responsible to pay reasonable collection expenses including court costs, credit verification expenses and attorney fees.
• If the patient/guarantor is unable to pay the hospital bill, or cannot make formal payment arrangements, notify hospital personnel immediately, in order to initiate time-sensitive applications for state, federal, or hospital programs.

Discount Eligibility for Insured Patients

• Medicare: The patient share is not eligible for a discount because the reimbursement for services is determined by the program and is apportioned between the Medicare payment and the beneficiary deductible and coinsurance amounts. Medicare expects the beneficiary to pay their share in full and the provider is expected to be in compliance.
  
  Non-covered services and services for which an Advanced Beneficiary Notice has been issued are eligible for a discount.
  
• Contracted Insurance: The patient share is not eligible for a discount because the contracted amount is apportioned between the insurance and the patient. The charges are already discounted, and no further reduction is available.
  
  Non-covered services are eligible for a discount.
  
• Non-contracted Insurance: Patients may receive a discount on their portion.

Discount Eligibility for Uninsured Patients

Basic financial assistance is provided for uninsured patients who sign an affidavit indicating that their annual gross household income is less than 500% of the federal poverty guidelines (FPG) for a family of four.

• $110,000 is 500% of the 2009 FPG for a family of four.
• A basic financial assistance adjustment of 75% will be applied to the billed charges.
  
  - For scheduled services, the patient is expected to pay 25% of the estimated charges at the time of service.
  
  - For non-scheduled services, the balance must be paid within 12 months from the time the patient is informed of their charges.
• This adjustment is consistent with the average payer (insurance) reimbursement for hospital charges.
• The patient or responsible party is eligible to apply for additional assistance due to financial hardship or compassionate circumstances.

For patients who do not qualify for basic financial assistance, the hospital offers the following discount options:

• Seventy-Five percent (75%) discount option:
  
  - For scheduled services, the balance must be paid at the time of service
  
  - For non-scheduled services, the balance must be paid within 14 days from the time the patient is informed of their charges.
• Fifty percent (50%) discount option: when the balance is paid within 60 days from the time the patient is informed of the discount option.
• Forty percent (40%) discount option: when the balance is paid within 12 months from the time the patient is informed of the discount option.

Packaged services are excluded from discounts. These services include but are not limited to the following:

• Outpatient Clinically Supervised Exercise
• Outpatient Cardiac Rehab
• Outpatient Diabetic Education
• Adult Fitness
• Massage Therapy
• Nutrition Consult

The hospital offers prompt pay discounts for remaining balance after a portion is adjusted in a Financial Hardship circumstance. Discounts are not an option for balance after a Basic Financial adjustment.

Payment Arrangements

The hospital requires a minimum monthly payment of $50.

Maximum payment period is not to exceed 12 months from the date of agreement.

The monthly payment amounts do not have to be of equal amounts. Monthly payments may be increased or decreased throughout the timeframe of the agreement as long as the obligation is met, and the payments are not less than $50 per month.

Liens

In the event that another person or entity is responsible for the injuries giving rise to this treatment, the hospital retains its lien rights pursuant to A.R.S. 33-931, and will enforce its lien against any such recovery.