Sliding Fee Scale Policy & Application (PDF)

Jefferson Healthcare is committed to providing health care services to all people who are in need of medical attention, regardless of ability to pay. To demonstrate this commitment, Jefferson Healthcare signed the American Hospital Association Confirmation of Commitment, which states that the hospital and clinics’ policies and practices on charges, charity care, billing, and debt collection meet or exceed the principles and guidelines of the board of trustees of the American Hospital Association.

The credit policy of the hospital and clinics provides four options for self-pay or uninsured patients, depending on their level of financial need.

• If the patient has the means to pay his or her bill, a 10 percent discount is offered to self-pay patients for payment in full within 30 days of the postmark on the itemized bill.
• Patients who have the means but who need to spread out their payments may make monthly payments on their accounts, paying the balance in full within three months. When a more extended payment plan is needed, other arrangements may be made upon request.
• When patients do not have the means to pay their bills, a financial services representative will assist them in determining whether they are eligible for Medicaid.
• For patients not eligible for Medicaid and whose income is below 300 percent of the current federal poverty standard, the charity care and sliding fee scale programs are available.

The charity care policy is applied uniformly to all Jefferson County residents using Jefferson Healthcare for their healthcare needs. We treat all patients equitably and with dignity and respect. We make every effort to ask patients whether they need financial assistance to pay for part or all of the care they have received or will receive.

Why Private-Pay Charges May Appear to Be Higher

Private-pay charges may appear to be higher because third-party payers negotiate discounted charges as part of their contracts with providers. Medicare and Medicaid require providers to accept their level of payment if the hospital is to be paid directly.

Who Qualifies for Charity Care?

• Patients whose gross family income is at or below 100 percent of the current federal poverty level are eligible to receive charity care and have their full charges written off.
• Patients whose gross family income falls between 101 and 300 percent of the current federal poverty level are eligible for a reduction in their charges, based on a sliding fee schedule.
• Patients whose life circumstance indicates severe medical hardship may be eligible for charity care even if the family income exceeds 300 percent of the current poverty level. This is determined on a case-by-case basis.

Note: The federal poverty level varies with the number of family members and is periodically updated.

How Does a Patient Apply for Charity Care?

Upon request, the patient or responsible party will be given charity care forms and instructions. The patient will be asked to provide documentation of income.

At What Point in the Process May a Patient Apply for Charity Care?

Patients may apply for charity care at any point, from preadmission to final payment of the bill.

Is the Charity Care Application Confidential?

Yes. The information from the application is used solely for the purpose of qualifying the patient for Medicaid, charity care, or the sliding scale.

Our Collections Practices

We must make a reasonable effort to collect on those accounts that are due. We do not harass patients for payment or use collection agencies that use pressure tactics. Any patient who states that he/she does not have the means to pay the bill will be referred for financial counseling to determine eligibility for one of the helping programs.

How Do We Determine Charges?

To ensure consistency and fairness throughout our system, we base our charging methodology on the American Medical Association’s common procedural terminology codes. Our charges are in the midrange for rural hospitals. We realize that hospital charges are increasing and that the health care system is very complex. Therefore, we have made a significant effort to ensure that access to needed care is available.

What Situation May Disqualify a Patient?

If a patient is eligible for certain other programs, such as Medicaid, they may not qualify for charity care. Patients seeking charity care are not required to seek loans to pay for medical bills.