Charity Care Commitment
My Health My Resources (MHMR) of Tarrant County is committed to providing quality care to patients who are uninsured, underinsured, or otherwise unable to pay, for medically necessary care based on their individual financial situation. MHMR strives to ensure that the financial capacity of patient’s who need quality healthcare services does not prevent them from seeking or receiving care.
Ability to Pay Assessment
Services Eligible under this policy
For purposes of this policy, “charity care” or “financial assistance” refers to the healthcare services provided by MHMR without charge or at a discount to qualifying patients. The following healthcare services are eligible for charity care:
1. Behavioral health services
2. Immunizations
3. Public health services
4. Other preventative services
Eligibility for Charity Care
Eligibility for charity care will be considered for those patients who are uninsured, underinsured, and who are unable to pay for their care, based upon a determined financial need in accordance with this policy. The granting of charity care is based on an individualized determination of financial need, and does not consider age, gender, race, social or immigrant status, sexual orientation, or religious affiliation.
Method in Which Patients May Apply or be Assess for Charity Care
Financial need is determined in accordance with procedures that involve an individual assessment of financial need; and may include:
- An application or assessment process, in which the patient or the patient’s Legally Authorized Representative (LAR) are required to cooperate and supply personal financial and other information and documentation relevant to making a determination of financial need.
- The use of external publicly available data sources that provide information on a patient’s or LAR’s ability to pay (such as credit scoring).
- Include reasonable efforts by MHMR to explore appropriate alternative sources of payment and coverage from public and private payment programs and to assist patients to apply for such programs.
- Consider the patient’s available assets, and all other financial resources available to the patient.
- A review of the patient’s outstanding accounts receivable for prior services rendered and the patient’s payment history.
A request or assessment for charity care and a determination of financial need can be done at any point in the collection cycle but is preferred to be completed within the first 30 days of treatment. The need for financial assistance is re-evaluated annually and whenever a significant change has occurred which affects the patient’s or LAR’s eligibility for charity care.
Requests for charity care shall be processed promptly with notification to the patient or LAR in writing within 30 days of receipt of the completed application or assessment.
Presumptive Financial Assistance Eligibility
There are instances when a patient may appear eligible for charity care discounts, but there is no financial assistance form on file due to lack of supporting documentation. Often there is adequate information provided by the patient served or through other sources, which provide sufficient evidence to provide the patient with charity care assistance.
In the event there is no evidence to support a patient’s eligibility for charity care, MHMR can use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.
Once determined, due to the inherent nature of the presumptive circumstances, the only discount that can be granted is a 100% write-off of the account balance.
Presumptive eligibility may be determined based on individual life circumstances that may include:
- State-funded prescription programs
- Homeless or received care from a homeless clinic
- Participation in Women, Infants, and Children programs (WIC)
- Food stamp eligibility
- Subsidized school lunch program eligibility
- Eligibility for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down)
- Low income/subsidized housing is provided as a valid address; and
- Patient is deceased with no known estate
Eligibility Criteria and Amounts Charged to Patients
Services eligible to patients on Sliding Scale Fee Schedules, in accordance with financial need, as determined in reference to Federal Poverty Levels (FPL) in effect at the time of determination. The basis for the amounts charged to patients served who qualify for financial assistance is as follows:
- Patients whose family income is at or below 150% of the FPL are eligible to receive services at a discount of 100%
- Patients whose family income is above 150% but not more than 200% of the FPL are eligible to receive services at a discount (partial charity care) at rates discounted using Sliding Scale Fee Schedules. Uncollected fees assessed are Bad Debt and ineligible for reimbursement under federal charity care programs.
- Patients whose family income exceeds 200% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence; however, the discounted rates shall not be greater than the amounts generally billed to private or public insurance and discounted using Sliding Scale Fee Schedules. Uncollected fees assessed are Bad Debt and ineligible for reimbursement under federal charity programs.
Communication of Charity Care Program to Community
MHMR widely publicizes a summary of this charity care policy on the website, in brochures available in patient access sites and other places within the community. Such notices and summary information are provided in accordance with MHMR’s Competency Plan.
Notification about charity care from MHMR includes contact number, and is disseminated by various means, which includes, but are not limited to publication of notices in monthly statements and by posting notices in Centers, waiting areas, intake and assessment, and other public places as elected.
Relationship to Collection
MHMR takes into account the extent in which the patient qualifies for charity care, a patient’s good faith effort to apply for charity care, and the patient’s good faith effort to comply with his or her payment agreements.
For patients who qualify for charity care and who are cooperating in good faith to resolve their discounted bills, MHMR may offer extended payment plans, will not send unpaid bills to outside collection agencies, and will cease all collection efforts. MHMR will not impose extraordinary collections actions such as wage garnishments; liens on primary residents, or other legal actions as allowed by Texas and Federal law for any patient without first making reasonable efforts to determine whether that patient is eligible for charity care under this financial assistance policy. Reasonable efforts shall include:
- Validating that the patient owes the unpaid charges and that all sources of third-party payment have been identified and billed.
- Documentation that MHMR has attempted to offer the patient and opportunity to apply or be assessed for charity care pursuant to this policy and that the patient has not complied with the Center’s financial assessment requirements.
- Documentation that the patient does not qualify for financial assistance on a presumptive basis.
- Documentation that the patient has been offered a payment plan but has not honored the terms of that plan.
Regulatory Requirements
Implementation of this Policy does not negate or supersede compliance with all other federal, state, and local laws, rules, and regulations applicable to the services outlined herein.