Financial Hardship

We are looking to start a policy for financial hardship. I have a printed the Poverty guidelines and make sure to ask patient's for a copy of their tax return or bank statements.

Does anyone have any recommendations or examples of policies in your office? We have a patient who can't afford her Medicare injection copay and is over the poverty guidelines by $1,000. Any ideas, suggestions, comments would be great.

Financial Hardship

I worked with a community health center that owed back Hill Burton funds for their initial building. They had to give away a certain amount of free care. We used a sliding fee scale (probably more complicated than what you want to do) but we calculated 100%, 125% 150% 175% and 200% of the poverty guidelines, and set different levels of charity discount based on that. We had to have our plan approved by the grants administrator periodically.

$1,000 over per month or per year?

Charity Care

IMHO, having a policy takes away the concept of charity. In private practice we are governed by compassion. But I think the "rule" from CMS is that you make an attempt to collect and then you can write it off. You cannot just waive the fee- that is fraud since Medicare is supposed to pay 80% of the fee and you therefore should get 80% of 80% (if that makes sense).

So for your patient, bill her as with all others then your docs can look at the delinquent list and determine who deserves a compassionate waiver of fees and write those off---and send the rest to a collection agency (with the charge jacked up to cover the collection fee.)