Lakeland Regional Medical Center, Inc. (LRMC) and Lakeland Regional Health Systems, Inc. (LRHS), collectively Lakeland Regional Health (LRH), are committed to serving the community by helping to promote community-wide responses to patient needs, in partnership with government and private organizations. In order to promote the health and well-being of the community served, individuals are eligible for free or discounted healthcare services based on established criteria. Eligibility criteria are based upon the Federal Poverty Guidelines (FPG) and are updated in conjunction with the FPG updates published in the Federal Register by the United States Department of Health and Human Services.
Financial Assistance Guidelines
To be eligible for a 100% Financial Assistance Adjustment (i.e. full write-off), the patient’s household income, adjusted for family size, must be less than or equal to 200% of the current Federal Poverty Guidelines. If the patient’s household income, adjusted for family size, is between 200% and 400% of the Federal Poverty Guidelines, the patient shall be eligible for a 75% Financial Assistance Adjustment that is based upon LRMC’s Amounts Generally Billed (AGB) percentage. An uninsured patient whose income is greater than 400% of the Federal Poverty Guidelines will receive an Uninsured Discount of 75% that is based on the AGB percentage. Uninsured patients of LRHS (including those seen in an office setting) will receive an Uninsured Discount of 30%.
At no point will an individual be charged more for emergency or other medically necessary care at a LRMC facility which is more than those generally billed to individuals who have insurance coverage. If a patient is determined to be eligible for a Financial Assistance Adjustment for a service provided at a LRMC facility, the applicable Financial Assistance Adjustment will be applied to any related services provided by LRHS employed providers at the LRMC facility.
For non-emergent or non-urgent services, only those patients residing in the LRMC primary service area will be eligible for financial assistance pursuant to this policy. The following zip codes make up the LRMC primary service area: 33801, 33803, 33805, 33809, 33810, 33811, 33812, 33813, 33815, 33823, 33849, 33860, 33868, 33802, 33804, 33806, 33807, 33835, 33840, 33846, 33863.
Determination of Eligibility
Reasonable efforts will be taken to determine if a patient is eligible for Financial Assistance. During the first 240 days after the first post-discharge or post-service (for Outpatients) billing statement, LRMC or LRMC’s agent (i.e. a Collection Agency) will notify the patient about the Financial Assistance Policy. The patient will receive at least three billing statements that include language about applying for financial assistance and will receive one written notice that informs the patient that credit bureau reporting may be initiated if financial assistance is not applied for or the account is not paid.
All patients identified as potential financial assistance recipients will be offered the opportunity to apply for financial assistance. If this evaluation is not conducted until after the patient is discharged, or in the case of outpatients or emergency patients, a LRMC representative will mail the appropriate Financial Assistance Application to the patient. If the Financial Assistance Application is incomplete, the hospital will provide the individual with a written notice that describes the additional information and/or documentation needed to complete the application.
All patients requesting Financial Assistance will be required to complete a Financial Assistance Application and provide the requested supporting documentation needed to verify eligibility. The application shall include a witnessed statement signed by the patient or responsible party. One or more of the following forms of income verification may also be requested or used to validate information provided on the application:
- PARO/Search America or other presumptive eligibility tools
- Current pay stubs
- Income tax returns
- Form approving or denying unemployment compensation or workers’ compensation
- Written verification of wages from an employer
- Written verification from public welfare agencies or any governmental agency of the patient’s income
- A Medicaid remittance voucher which reflects that the patient’s Medicaid benefits for the Medicaid fiscal year have been exhausted
- Self-employed patients or patients owning income-generating property may be required to provide detailed income and expense information pertaining to their business or investment properties.
Notification of Eligibility Determination
A written decision regarding eligibility is provided to the patient. This notification will state the amount of financial assistance (for approvals) or a reason(s) for denial. LRMC will provide a billing statement to the individual that indicates the amount owed, if any, shows or describes how the patient can get information regarding the AGB percentage for the care provided and how the discount was determined.
Availability of Forms and Policy
For more information, be sure to review our Financial Assistance Policy and download our Financial Assistance Application. For additional assistance, please call a Patient Account Representative at 863.687.1196.
Billing and Collections Policy
Information regarding LRH’s Billing and Collections Policy can be viewed here.
Providers Not Covered by the Financial Assistance Policy
Certain medical providers that practice in the hospital or assist with care may be private practitioners and not employed by LRMC. A bill comes from the hospital and separate bills are sent from each medical provider that provides care in the hospital. Non-employed medical providers that practice at LRMC are not required to follow the Financial Assistance policy. Further information about the assistance or payment arrangements a non-employed medical provider may offer can be obtained by contacting the provider directly.
A listing of all non-employed medical providers that perform services at the hospital and not covered by the Financial Assistance policy can be viewed here. The listing will be updated quarterly.
Patient Billing Inquiries
If you have questions regarding the bill you received from LRH, please contact Patient Financial Services using the information below.
Medical Center/Hospital Inquiries:
Lakeland Regional Medical Center, Inc.
230 South Florida Ave., First Floor
Lakeland, Florida 33801
LRH Physician and Professional Billing Inquiries
Lakeland Regional Health Systems, Inc.
1730 Lakeland Hills Blvd.
Lakeland, Florida 33805
Phone: 863.284.5000 Option# 4