Patient finance policies approved

Tuesday evening, the Hot Springs County Memorial Hospital Board of Trustees approved two policies with regard to patient financial services. Prior to approval, Chief Financial Officer Shelly Larson provided a brief summary of each.

The Financial Assistance Policy applies to all emergency and medically necessary care. It provides discounts for those determined to be eligible, and it is required to be widely publicized.

The policy lays out that the hospital will provide uncompensated healthcare to residents of the state of Wyoming, it will be consistently administered and there will be no discrimination based on factors such as age, race, sex or religion. One stipulation is that assistance is provided based on the budget.

With regard to the budget stipulation, Larson pointed out the hospital cannot provide unlimited healthcare assistance. There is a line item for assistance, and another for bad debt.

Larson also mentioned charity care would be allowed for a year after an application is filled out; now it is every six months. This helps in cases where people might have changes in income, and goes to ensure charity really goes to those who need it.

As for eligibility, patients will be considered for charity or discounted billing based on their ability to pay and the Federal Poverty Guidelines (FPG) issued and updated annually.

When household income is less than 100 percent of the FPG, a 100 percent discount from gross charges applies. When total household income is 101-150 percent of FPG, an 85 percent discount applies; total household income is 151-200 percent of FPG, a 65 percent discount applies; total household income is 201-250 percent of FPG, a 50 percent discount applies; total household income is 251-300 of FPG, a discount applies based on the amounts generally billed (AGB).

The hospital determines AGB based on all claims paid in full by Medicare and private health insurers — including payments by Medicare beneficiaries or insured individuals themselves — over a 12-month period, divided by the associated gross charges for those claims.

There is also an appeal process for those who feel they should’ve received charity or discounted billing and did not.

Board Chair Bill Williams said the policy is important to have, and is “light years ahead of where it was 10 years ago.”

Also approved is the Billing and Collection Policy. Larson explained the policy requires a reasonable effort be made to determine if patients are eligible for financial assistance, before any extraordinary collection action is taken, including reporting to the collection agency and legal action. The policy specifies what kind of contact has to happen, which includes four separate statements and at least one oral contact.

Larson noted the policies are a significant upgrade from what was previously in place, and they are requirement as the hospital is a 501(c)(3) organization under 501(r). She further noted the policies really tie back to providing a service to the community, which is part of being a tax-exempt entity.

Also approved at the meeting was a $2,125 bid from Central Wyoming Tree Service to address trees on the lots across the street from the hospital. Larson said the item was not budgeted, though the renters requested something be done. The bid includes tree trimming as well as some stump removal, and the renters’ concern is that tree limbs might fall on their roofs.

A management contract and a compliance consulting services agreement, both with Health Tech, were approved following an executive session.

An item discussed, but not acted upon, was renewal of a line of credit of about $1.2 million. Larson noted this line might have been put in place during a time when claims were slower coming in than going out, and she would be getting proposals from local banks. The line has been with Bank of Thermopolis in the past.