Uninsured Patients

The patient is registered by the Admitting Registrar who will identify the patient as having no medical insurance (self pay).

The patient will be given a Financial Assistance Pamphlet that will identify all Griffin Hospital Free Care Assistance programs. The pamphlet also includes hospital contacts for patients seeking State welfare, SAGA (City welfare), or other State programs.

Patients who register as having no medical insurance with account balances over $3,000 will be referred to the hospital Eligibility Worker. The patient will be seen within 24 hours of admission. If the Eligibility Worker is unable to fulfill this requirement due to absence, the Financial Advisor will take the necessary steps to fulfill this requirement. All accounts under $3,000 will be referred to the hospital Financial Advisors.

The hospital eligibility worker will complete a financial screening for those patients seeking Title 19 eligibility and for the uninsured status.

The hospital Eligibility Worker will identify patients meeting the State/SAGA and HUSKY program criteria. For patients meeting the criteria, the application process will be completed and all paperwork forwarded to the appropriate State department for processing.

The patients who do not meet the criteria for the State/SAGA/HUSKY programs will be referred to the hospital Financial Advisor.

The Financial Advisor will begin a review to determine if the patient meets the uninsured criteria identified in Public Act 03-266. A letter will be sent to the patient requesting that patient to verify that they do not have medical insurance as identified during their hospital registration process. The letter will also request additional patient information regarding the patient’s income if necessary. The criteria the patient must meet as identified in Public Act 03-266 are as follows:

• Patient’s income, based on family size, falls under 250% of the poverty income guidelines (poverty income guideline scale available upon request)
• Hospital has made a full determination as to the status of the State/SAGA/HUSKY programs (if applicable)
• All Griffin Hospital Free Bed Funds have been reviewed and determined non-applicable for the patient in review

If the patient responds to the letter sent out by the Financial Advisor, this will begin the application process for the verification of the uninsured patient status. The following information will need to be finalized with the patient in order for the uninsured determination to be made:

• Proof of patient income and family size
• Hospital has made a final determination as to the status of the State/SAGA/HUSKY programs (if applicable)
• Verification of all Free Bed Funds being reviewed with the patient

Upon determination that a patient meets the outlined criteria, the patient will be classified as follows:

• Uninsured Status; the patients account will be taken from total gross charges and reduced to cost by applying factor supplied annually by the Office of Health Care Access
• The patient will be informed of this decision and will be sent a letter that will reflect the balance at reduction on all applicable accounts
• The patient will be advised of the balance that is due and payable

The Financial Advisor will contact the patient to accomplish the following:

• Attempt payment arrangement with the patient on the remaining balance
• If the patient identifies to the Financial Advisor that they cannot afford the remaining balance, an application for Free Care Assistance will be completed (see Free Care Assistance Policy and Procedure)

If a patient applies for Free Care Assistance, the Financial Advisor will make a decision on Free Care eligibility based on the patient’s family size and income. Free care will be offered based on the Griffin Hospital Free Care Assistance sliding scale (sliding scale available upon request).

The Financial Advisor will advise the patient of the free care determination that will be applied to the patient’s remaining balance.

The Financial Advisor will complete all appropriate logs with the decisions and amounts.