ADMINISTRATIVE POLICY
FREE OR REDUCED-FEE HEALTH CARE
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To acknowledge in written policy the existing practice and responsibility of this organization under section 501(c)(3) of the Internal Revenue Code to provide care, consistent with the scope of services provided by this organization, to indigent persons regardless of their ability to pay.
To define a process for determining the eligibility of a patient for free or low cost health care services.
Policy:
Otis Health Care Center, as an integral part of its health promotion
mission and its community benefit responsibility, shall provide free or
low
cost services to patients in need of them. Necessary clinical evaluation
and
care shall not be delayed, limited, withheld or withdrawn in order to
inquire about or to determine eligibility for free or low cost services,
or
based upon a determination that the patient does need such services.
Procedure:
I. Determination of Need
A. An individual who indicates that s/he does not have health insurance coverage and/or is unable to pay for health care services shall be referred to the Business Office.
B. The Business Office shall give the individual written information and verbal explanation about eligibility for free and reduced-fee care.
C. An individual requesting free or reduced-fee care shall be requested to provide to the Business Office the following documents:1. a completed “Application for Free or Reduced-Fee Health Care” form (see Attachment I) and
2. a copy of his/her most recent tax return.
D. Determination of Eligibility
1. Eligibility shall be determined by evaluation of the information listed above and by reference to the current Federal Poverty Guidelines as established by the United States Department of Health and Human Services, which shall be on file in the Business Office and made available to applicants for free or reduced-fee care upon request.
2. If the individual does not specifically qualify for free or reduced-fee care, but can substantiate circumstances that make payment onerous, the administrator or his designee may authorize free care, reduction of fee(s) and/or an installment payment plan acceptable to the patient and Otis Health Care Center.
II. Record-Keeping
A. The Business Office shall keep detailed records of all free care and reduced-fee care provided.
B. Practitioners shall always submit to the Business Office the usual and customary forms documenting services provided, although a notation regarding the recommendation or request for free care may be added.
| EFFECTIVE DATE: | November 22, 2002 |
| Rev. 2008 |
APPPROVED: Albert LaRochelle, Administrator
Attachments: (PDF format)
- 2008 POVERTY LEVEL GUIDELINES
- SLIDING FEE SCALE (PDF)
- APPLICATION FOR FREE OR REDUCED-FEE HEALTH CARE (PDF)
