Renown Policy v2021 Page 2 of 4
Exceptions are subject to leadership approval.
5. Reasonable Efforts mean that Renown will notify the individual about the FAP before initiating ECAs and will refrain from initiating ECAs for at least 120 days from the date of the first post discharge billing statement. Additional information regarding this definition can be found in IRS guidelines 1.501( r)- 6 Billing and collection.
6. FAP-Eligible Individual means a Guarantor eligible for financial assistance under the Financial Assistance Program without regard to whether the individual has applied for assistance.
7. Financial Assistance Program( FAP) means Renown’ s Financial Assistance Program for uninsured patients and underinsured patients, which includes eligibility criteria, the basis for calculating Financial Assistance, the method for applying, and approval.
8. Guarantor( s) means the patient and any other individual( s) responsible for the account. There may be more than one Guarantor( s) and there may be more than one hospital billing / professional billing account within the Guarantor( s).
9. Self-Pay Account means the portion of a patient’ s account that is the individual( s) responsibility of the patient or other Guarantor( s). This amount is net of payments made by any available healthcare insurance or other third-party payer( including co-payments, co-insurance and deductibles), and net of any discount.
10. Fair Debt Collection Practices Act( FDCPA) are federal regulations used for collection activity guidance http:// www. ftc. gov / os / statutes / fdcpa / fdcpact. htm.
11. Self-Pay Discount Discounts applied to uninsured or underinsured patients excluding package or same day self-pay discounts.
12. Payment Arrangements The option to pay for an outstanding balance over time. This applies to uninsured and insured self-pay patient balances.
Policy: Subject to compliance with the provisions of this policy, Renown may take all legal actions, including Extraordinary Collection Actions, to obtain payment for medical services provided.
• Insurance Coverage verification: The Renown Health Revenue Cycle department( s) verifies coverage eligibility for services provided to all self-pay patients.
• For any federal and / or state government reimbursement grants in which Renown Health is to be reimbursed for services provided to uninsured patients, insurance coverage verification will be required prior to submitting to the federal or state agency for reimbursement. This is to ensure all submissions for reimbursement have been verified to not have insurance coverage at the time patient care was provided.
Billing Cycle: At least four separate statements for collection of the Self-Pay Account shall be mailed or emailed to the last known address of the Guarantor. At least 120 days shall have elapsed between the first and the required four mailings.
a) It is the Guarantor obligation to provide a correct mailing address at the time of service or upon moving. If an account does not have a valid address, the determination for“ Reasonable Effort” will have been made.
These Policies and Procedures are guidance for the Organization. The Organization recognizes there may be specific facts and / or circumstances that warrant a departure from a specific policy provision. Nothing herein is intended to override an employee’ s ability to use good judgment in such circumstances.