Community Care Policy

TMC HealthCare Community Care Policy

Policy:

In keeping with TMC HealthCare’s commitment to our community and our mission to deliver caring, personalized, quality healthcare, services will be made available to all patients regardless of ability to pay. When appropriate, TMC HealthCare staff should determine if a patient account qualifies for community care.

Purpose:

The purpose of the community care allowance is to identify the patients who lack the financial resources to pay for all or part of their bill and to process appropriate adjustments for charges incurred.

Definition:

Community Care Allowance is the last alternative to be used to forgive indebtedness. All other available resources, including applications to state and federal resources should be explored and exhausted prior to consideration of any allowance. Community Care Allowance is offered on a case-by-case review only.

Guidelines:

  1. Patients that have no other financial resources available will be evaluated for financial assets and ability to pay based on the current year’s federal poverty guidelines to determine level of allowance available. In the event the patient is a non-resident, a financial asset evaluation will still be used to determine ability to pay.
  2. In the event of an urgent or emergent situation, patients that have a funding source, but indicate they are financially unable to meet the self pay obligation will be evaluated for financial assets and ability to pay, based on the current year’s federal poverty guideline to determine level of allowance available.
  3. Other options available for payment, which must be exhausted prior to the completion of a Community Care request include:
    1. Unable to take advantage of quick pay discount.
    2. Loan score and application or means of making minimum monthly payments.
    3. Payments plan guidelines policy.
    4. State or federal funding denial or clearly not eligible for Medicaid programs.
  4. A completed financial application with copies of all requested information.
  5. All activity documented in patient account.

Process:

  1. The completed financial application is stapled to the “Charity/Finance Assistance Request” form with requestor’s signature and date.
  2. The forms and documentation are submitted to the appropriate level for approval or denial.
  3. If the application is approved, the total financial application package will be forwarded to Cash Application staff for posting and will be filed with daily batches.
  4. Once the finalicial application is posted to patient’s account, the requestor will send approval letter to patient/guarantor.
  5. If the request is denied, the forms are returned to the staff member who initiated the form.
  6. The staff member calls the patient and explains the application was denied.
  7. The staff member explains and documents other payment possibilities including the quick payment discount, loan program or payment plan.

It is understood that the hospital retains its hospital lien rights pursuant to A.R.S. – 33-931 et seq., to collect its charges filed with the Department of Health Services to the extent the patient has a claim against any person or entity responsible for the injury or illness resulting in this treatment.