X

Free Care Assistance

Policy & Procedure

Any patient requesting financial assistance in paying their Griffin Hospital bill can apply for the Free Care Assistance Program by contacting the hospital’s Financial Advisory staff.

The Financial Advisor will be contact by the patient to complete the Free Care application process.

The Financial Advisor will obtain the following information from the patient in order to complete the Free Care Application:

  • Patient W-2 form (tax statement from previous and current year)
  • Three consecutive pay stubs from patient’s current employment
  • Dependent information (family size)
  • Any or all bank and checking account statements

The Financial Advisor will refer to the Griffin Hospital sliding scale. This is based on the Federal Poverty Income Guidelines (sliding scale available upon request). The Financial Advisor will make a determination of free care eligibility status.

If the patient qualifies for Free Care Assistance, the applicable discount percentage will be applied to the patient’s account balance.

If a patient balance remains, the Financial Advisor will pursue one of the following with the patient:

  • Require payment in full
  • Set up a monthly payment arrangement
  • If the patient does not maintain the agreed upon payment schedule, the account will be forwarded to an outside collection agency at the full remaining balance.

If a patient does not qualify for Free Care Assistance, the Financial Advisor will attempt to:

  • Obtain payment in full
  • Set up a monthly payment arrangement

If the patient does not maintain the agreed upon payment schedule, the account will be forwarded to an outside collection agency at the full remaining balance.

In some cases, it is necessary to override the policy guidelines on income due to “special” circumstance requirements, i.e., social admits, maxed out days, deceased patients. An override can be obtained by the Supervisor and Director or CFO allowing for consideration of eligibility.

The Collection Supervisor will maintain all monthly spreadsheets that will identify all Free Bed funds, Uninsured, and Free Care Assistance allocated on a monthly basis.

For insured and uninsured patients responsible for an Account Balance on or after February 1, 2015
Size of Family 1 2 3 4 5 6 7 8
250% HHS Poverty Income Guidelines

100% Free Care
$0 - 29,425 0 - 39,825 0 - 50,225 0 - 60,625 0 - 71,025 0 - 81,425 0 - 91,825 0 - 102,225
280% HHS Poverty Income Guidelines

85% Free Care
15% Patient Share
$29,426 - 32,956 39,826 - 44,604 50,226 - 56,252 60,626 - 67,900 71,026 - 79,548 81,426 - 91,196 91,826 - 102,844 102,226 - 114,492
310% HHS Poverty Income Guidelines

75% Free Care
25% Patient Share
$32,957 - 36,487 44,605 - 49,383 56,253 - 62,279 67,901 - 75,175 79,549 - 88,071 91197 - 100,967 102,845 - 113,863 114,493 - 126,759
340% HHS Poverty Income Guidelines

50% Free Care
50% Patient Share
$36,488 - 40,018 49,384 - 54,162 62,280 - 68,306 75,176 - 82,450 88,072 - 96,594 100,968 - 110,738 113,864 - 124,882 126,760 - 139,026
370% HHS Poverty Income Guidelines

35% Free Care
65% Patient Share
$40,019 - 43,549 54,163 - 58,941 68,307 - 74,333 82,451 - 89,725 96,595 - 105,117 110,739 - 120,509 124,883 - 135,900 139,027 - 151,293
400% HHS Poverty Income Guidelines

30% Free Care
70% Patient Share
$43,550 - 47,080 58942 - 63,720 74,334 - 80,360 89,726 - 97,000 105,118 - 113,640 120,510 - 130,280 135,902 - 146,920 151,294 - 163,560

Source: Federal Register, Vol 80, Number 14 (Thursday, January 22, 2015)., Pages 3236-3237

For family size with more than eight (8) members add $4,160 for each additional member.

This sliding scale is based on the 2015 HHS Poverty Guidelines for the 48 contiguous states and District of Columbia.

Open Print-Friendly Version of this Table

Events