Financial Assistance Policy
LRH is committed to serving its 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, uninsured and underinsured 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% reduction from charges, the patient’s household income, adjusted for family size, for the twelve months preceding the determination must be less than or equal to 200% of the current Federal Poverty Guidelines. If the patient’s household income, adjusted for size, is between 200% and 400% of the Federal Poverty Guidelines, the patient shall be eligible for a 75% reduction from charges. An uninsured patient whose income is greater than 400% of the Federal Poverty Guidelines will receive a discount that is annually calculated using a “look back” method.
At no point will an individual be charged more for emergency or other medically necessary care than those generally billed to individuals who have insurance coverage. This discount does not apply to those patients seeking elective procedures who reside outside of LRH’s primary service area.
Determination of Eligibility
Reasonable efforts will be taken to determine if a patient is eligible for Financial Assistance. For the first 120 days after the date of service, the hospital will notify an individual about the Financial Assistance Policy by including language on at least three billing statements informing them of the policy. The hospital will subsequently accept applications by an individual for up to 240 days after the patient receives the first billing statement for the care rendered.
All patients identified as potential financial assistance recipients should 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, an LRH 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.
Notification of Eligibility Determination
A written decision regarding eligibility is provided to the patient. This notification includes the amount of the assistance (for approvals) or a reason(s) for denial. The hospital 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 amounts generally billed for the care provided and how the discount was determined. The hospital will refund any excess payments made by the individual and reverse any extraordinary collection activities to include removing any adverse information reported to a consumer reporting agency or credit bureau.
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 our Customer Service Department at 863.687.1196.