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Important provisions to include in your charity policy

Patient Financial Services Weekly Advisor, April 23, 2004

Your policy on accepting patients as charitable cases is an important piece of the revenue cycle puzzle that should be kept in check. Sandra J. Wolfskill, FHFMA, president of Wolfskill & Associates, Inc., offers a lesson from a large teaching facility that coordinates charity processing with associated physician practices.

Its charity policy indicates the following:

• A financial statement is required
• Charity determinations are based on a combination of income levels and net assets
• Written determinations are required
• The appeal process is fully outlined
  

The policy includes these provisions:

• Medicaid-eligible patients will receive charity for noncovered days
• Bankruptcy qualifies upon receipt of notice; proof of claim required unless patient has no assets
• Medically needy determination
• Impoverished by reason of long-term, catastrophic illness
• Approval is denied if Medicaid or other health-and-welfare eligibility application refused by patient
• Assignment to hospital of all insurance payments, including liability settlements, required
• Application will be accepted after legal collection activity initiated; patient required to reimburse hospital for legal costs incurred
• Hospital will use credit reports, as appropriate (patient is required to execute release)
• Hospital reserves the right to amend guidelines as appropriate to its mission and values

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