Patients & Visitors

Financial Assistance and Charity Guidelines

The Financial aid and charity policy of the hospital is consistent with the mission and values of the hospital recognizing that all patients are expected to contribute to their care based on their individual ability to pay.

Baptist Health offers charity to patients as a gift. Charity is not subject to race, sex, or creed. Charity is provided for all service types including emergency medical conditions. There is no future reimbursement expected from the patient unless there is subsequent insurance or liability recovery to the patient. Once an application is accepted, the approved charity discount will apply to an individual's charges for a period of sixty (60) days, after which the individual is required to complete another Application for Assistance with updated information and supporting documentation. Additional details regarding charity are also available as part of the Baptist Health Financial Services Hospital Collection Policy.

The Application for Assistance is for hospital charges only and will not apply to physicians, Radiology Consultants, Pathology Labs of Arkansas, or any other outside services.

Patients without insurance or without eligibility for any third party payment or reimbursement, including governmental coverage or assistance, will automatically receive twenty percent (20%) of billed charges uninsured discount. If the amount is paid within 30 days of discharge, uninsured patients will receive an additional 25% discount. (25% of the remaining 80% = 20%, so the total uninsured and prompt pay discount could be 40%.)

Additional charity discounts (up to 100%) may be provided based on evaluation of a completed Application for Assistance form with the required supporting documentation.

Charity may be applied for by completing an Application for Assistance and providing all required documentation (see below). The Application for Assistance is available at all Baptist Health Facilities and clinics (including community care clinics) or click here to download the assistance form. The Application for Assistance may also be requested by calling Patient Balance Services at (501) 202-3900. The form is also available in Spanish.

To be eligible for assistance, the following steps must be completed:

1. Answer all questions completely.
2. Sign and date the Application for Assistance.
3. Attach a copy of all required documentation (see below).
4. Return the Application for Assistance with required documentation.

Required Documentation (as applicable):

1. Signed Application for Assistance;
2. If applicable: complete copy of most recent Tax Return with attachments;
3. If Patient does not file taxes: proof of earnings (check stub, payroll record, or letter from employer);
4. If applicable: Proof of Disability (Social Security Administration Benefits Letter)
5. In some cases, additional documentation may be required to determine eligibility.

Patients whose accounts are eligible for Medicaid payment but have a balance remaining as the result of benefit limitations or "out of pocket" expenses will be considered eligible for the settlement of the remaining patient balance without application.

Patients who do not provide the requested information necessary to completely and accurately assess their eligibility may not be eligible for Charity. In addition, patients seeking Charity are expected to cooperate with any efforts to secure other healthcare coverage or sponsorship prior to Charity determination.

Eligibility is determined using objective criteria respecting the responsible party's income, assets and liabilities, age, and ability to work.

Income

Applicants with a household income below 300% of the Federal Poverty Guideline (including income from rental properties) will be considered for full charity. For those applicants with a household income in excess of 300% but not exceeding 400% of the Federal Poverty Guideline, a sliding scale will apply based on income and the number of people in the household.

Assets and Liabilities

Applicants with assets less than $8,000 (individual) or $12,000 (combined household) will be considered for full Charity. For individual applicants with assets in excess of $8,000 but less than $12,000, a sliding scale will apply based on assets. For those applicants with combined household assets in excess of $12,000 but less than $18,000, a sliding scale will apply based on assets and the number of people in the household.

All assets shall be considered for charity qualification upon application EXCEPT:

1. Applicant's primary residence (including the land / property on which that residence is located
2. One vehicle per person (two per household)
3. Retirement assets (defined as those assets - such as a 401K - where the IRS has granted preferential tax treatment as a retirement account including but not limited to deferred-compensation plans qualified under the IRS code, or non-qualified, deferred-compensation plans)
4. Cash / surrender value of life insurance policies, and,
5. Burial funds

Age

Applicants of all ages are eligible for Charity.

Patients may also qualify for Presumptive Charity. Presumptive Charity is defined as assistance available to persons who meet at least one of the criteria outlined below and are without a payor source for the services rendered. The criteria include:

1. Patient is expired with no immediate or known family members
2. Patient is homeless
3. Patient has qualified for Medicaid within the last 24 months
4. Patient is in hospice and has Medicaid coverage
5. Patient is within the financial eligibility levels for Medicaid as predicted by the capacity to pay model but is unwilling or unable to comply with the application process
6. Patient currently has Medicaid but has a prior balance

The above Charity policy is intended to serve as a limitation of charges to insure that patients eligible for financial assistance will be charged no more than amounts generally billed to individuals who have insurance and and is applied in accordance with the Baptist Health Financial Services Hospital Collection Policy. This Charity policy is made widely available to the public at all Baptist Health Facilities and on the web at http://www.baptist-health.com/patients_visitors/charity/. It can also be requested by calling Patient Balance Services at (501) 202-3900 or by sending a written request to ATTN: Patient Financial Aid Office -10802 Executive Center Dr. Ste 111, Little Rock, AR  72211.

Approved by the Board of Trustees on December 14, 2010.

This policy update will go into effect on January 1, 2011.