Beebe Healthcare is a not-for-profit, community-based healthcare facility organization. It is the organization’s policy that no one will be denied medically necessary hospital and/or medical group services based upon the patient's ability to pay for those services. A public notice of the availability of financial assistance will be visible within the hospital and medical group as well as on the organization’s website. Beebe Healthcare will comply with all federal, state, and contractual laws, regulations, and requirements.
The patient or guarantor has the ultimate financial responsibility for care received from Beebe Healthcare to include both hospital and medical group services. Beebe Healthcare will cooperate and assist all patients in the fulfillment of their financial responsibility. This cooperation includes payment arrangements, assistance with enrollment in public or private insurance programs, charity-based programs, financial assistance programs, or other third-party programs. Patients have the responsibility to provide timely and accurate information when seeking consideration under the Beebe Healthcare Charity and Financial Assistance Policy.
Scope
Beebe Healthcare (includes both hospital and medical group services)
Services Eligible Under This Policy:
For purposes of this policy, “charity” or “financial assistance” refers to healthcare services provided by Beebe Healthcare without charge or at a discount to qualifying patients. The following healthcare services are eligible for charity:
- Emergency medical services provided in an emergency room setting
- Services for a condition which, if not promptly treated, would lead to an adverse change in the health status of an individual
- Non-elective services provided in response to life-threatening circumstances in a non-emergency room setting
- Continued medical services provided within the hospital setting in which a patient is not safe to be discharged
- Services provided within or subsequent to an order from a School Based Wellness Center
- Medically necessary services, evaluated on a case-by-case basis at the organization’s discretion
Policy
Uninsured or Underinsured Payment Policy: Uninsured, Underinsured patients, or patients who designate themselves as self-pay at time of registration may be offered a discount of 15% of billed charges for hospital services and/or medical group services. (Exclusions may exist based on specific 3rd party payer or insurance contract agreements)
Financial Assistance Policy: Uninsured or Underinsured patients with family income up to 400% of the current Federal Poverty Level may be eligible for participation in the hospital and medical group's charity program unless specific exclusion is noted. A charity discount of 59% of billed charges will be granted to qualified persons with family incomes between 201% and 400% of Federal Poverty Level who complete the application for financial assistance and have been approved for assistance.
A patient may be deemed ineligible under the Charity Policy if, in the judgment of Beebe Healthcare, the patient is eligible for Medicaid, the Insurance Market Place or other third-party reimbursement programs and refuses to apply for those benefits. Approval of the Beebe Financial Assistance program will remain in effect for a period up to one year unless eligibility changes.
Individual/family eligibility will be determined by proof of income and additional required documents as determined through:
- Pay stubs or required income documents
- Bank Statements from the most recent month for all accounts
- Written statements from employer attesting to income
- All self-employed applications must submit the entire tax return including all schedules or the most recent Profit and Loss statement.
- Social Security award letter, Disability, Pension statement, Alimony, Unemployment letter, etc.
Proof of residency as verified by Delaware driver's license Residents of Beebe's primary service area eligible for charity policy are:
19930 Bethany Beach
19939 Dagsboro
19941 Ellendale
19944 Fenwick Island
19945 Frankford
19947 Georgetown
19951 Harbeson
19958 Lewes
19960 Lincoln
19963 Milford
19966 Millsboro/Long Neck
19967 Millville
19968 Milton
19969 Nassau
19970 Ocean View/Clarksville
19971 Rehoboth Beach/Dewey Beach
19975 Selbyville
- Residency requirements may be waived in the event of medical emergencies, approved Oncology services, Medicaid Non-Covered Denials due to Out-of-State Medicaid cases that Beebe does not have a Provider Enrollment with.
- Enrollees approved in the Health Care Connection (HCC, formerly CHAP) or Delaware Medicaid Programs are granted coverage under the Beebe Charity Care Policy for any patient balances with Beebe Healthcare for both hospital and medical group services upon completion of required application after appropriate fee schedule payments or discounts are applied.
- LaRed designated patient referrals may be eligible.
Failure to comply with the payment plan after the Financial Assistance write off may result in further collection activity.
Procedure
A. Processing Guidelines:
- Patients have 240 days from the date of their first post-discharge bill to apply for financial assistance.
- Notification of financial assistance application determinations will be mailed to the patient/guarantor within 30 days of receipt of a completed application.
- A patient may be deemed ineligible under the policy if the patient has disposable assets that exceed $7500 per household.
Beebe Healthcare will not require debt payment that forces a family, either insured or uninsured, into "medical indigency" as defined by Beebe Healthcare’s calculation of "medical indigency" based upon income and disposable assets.
B. Notice of Financial Assistance
Beebe Healthcare’s mission is to provide quality care to all who need it, 24 hours a day, seven days a week, 365 days a year. It is our hospital and medical group policy that no one will be denied medically necessary care based upon the patient's ability to pay for those services.
If a patient is ineligible or exempt from Health Insurance under the Affordable Care Act or may need assistance with balances after Insurance and worry that they may not be able to pay for part or all of their hospital and medical group care, Beebe Healthcare provides financial assistance to patients residing within the organization’s primary service area based upon income and financial need. In addition, we may be able to help the patient to receive government-sponsored health insurance, or work with the patient to arrange a manageable payment plan.
Federal and state law requires all hospital and medical groups to seek payment for care provided. This means we could ultimately turn unpaid bills over to a collection agency. Therefore, it is important that the patient let us know if they may have a problem paying their bill, or if they have any questions or concerns about paying their bill.
Some Beebe Healthcare related provider services will be billed separately from the hospital and medical group, and the patient will need to contact the providers regarding possible financial assistance. If the patient receives a bill from the following associated providers, please give them a call regarding their individual financial policies:
- Allied Diagnostic Pathology Consultant Delaware Anesthesia Associates
- Delmarva Radiation Services Southern Delaware Imaging Associates
- Sussex Emergency Associates
The Beebe Healthcare Financial Assistance program will remain in effect for up to a period of one year from approval date based on eligibility status. If the patient is currently active under the CHAP/HCC or Delaware Medicaid Program the patient may remain active under Beebe Healthcare’s program until their CHAP or Medicaid Program expires or until eligibility changes.
For more information, patients may contact a Financial Counselor by calling 302-645-3546. All information provided to Beebe Healthcare is considered confidential.
Screening for Life and Health Care Connection (HCC formerly CHAP) are Programs for uninsured Delaware residents who meet specific requirements. The programs are administered by the Delaware Health Care Commission.
C. Discounted Balances using Amounts Generally Billed Calculation
It is the policy of Beebe Healthcare to utilize the Amounts Generally Billed (AGB ) calculation in determining financial liability for those patients who qualify for financial assistance. AGB is calculated as the percentage of the allowable amount for emergency and medically necessary services divided by the total associated charges using the “look back” method for claims allowed by Medicare fee-for-service and all private health insurers that paid claims to the facility during a prior 12-month period.
D. Notification to Patients
- Signage indicating the availability of financial assistance is posted in English and Spanish in Patient Accounts, Patient Access, the Lab, Physician Practices and Satellite locations. Financial Assistance policy documents are also widely available on the hospital’s public website.
- A series of monthly statements will be sent to patients with a balance following discharge. Each statement will remind the patient of the availability of assistance through the hospital’s financial assistance program if the eligibility criteria are met. At least 30 days prior to referral for any extraordinary collection activity (ECA), a final statement and a copy of the Financial Assistance Policy Plain Language Summary will be mailed to the patient/guarantor. For further information about the ECA process, please refer to the Credit and Collection Activity Policy HWP 12048.
E. Family definition/Gross Family Income
For the purpose of determining gross family income and qualifying accounts for financial assistance:
- Family members are only immediate family members when they are the applicant, spouse, children (biological or adopted) under the age of 18.
F. Eligibility Determinations
The provision of health care should never be delayed pending an assistance eligibility determination.
- Patients must submit all required pieces of documentation within 30 days of application submission to be considered complete. A letter of the hospital’s intent to deny and close an application due to missing information will be mailed to the applicant at day 31.
- Application to the Beebe Healthcare Charity and Financial Assistance Programs can be submitted up to 240 days from the date of the first post-discharge bill and will be in effect for 1 year forward from the date of initial service.
- Acceptable verification of income includes the following:
• Last 3/12 months payroll check stubs.
• Most recent P&L statement if self-employed.
• Schedules C from tax return if self-employed.
• Schedule E from tax return for other real estate or rental income
• Written verification from employer (or pay stubs) verifying income for the last 3 months.
• Copies of any pension, alimony, or other sources of income
• Copies of social security earnings
• Any other information felt to be pertinent. - If bank accounts exist, we will need the most recent bank statement for each account.
Falsification of application will result in the prospective or retrospective denial of financial assistance benefits.
As financial assistance is a program of last resort, an application will not be considered until the applicant has been screened for other insurance or assistance programs, and it has been validated that all other sources of payment have been exhausted.
G. Presumptive Eligibility
Patients may be eligible for a discount of the full unpaid balance in the absence of a completed Financial Assistance Application Form if the patient meets one of the following:
- Is homeless or resides in low income/subsidized housing.
- Is deceased.
- Is currently eligible for Medicaid (as primary insurance) but was not at date of service, or Medicaid benefits are exhausted, or charges for services that are Non-covered by Medicaid, or patient is eligible for ER/L&D Medicaid only.
- Is currently eligible for Rx Assistance, SNAP/Food Stamps or WIC.
- Is eligible to receive benefits from a governmental agency as the victim of a violent crime or sexual assault and the treatment is related to the violent crime or sexual assault.
- A demonstrated inability to pay for services based on all available assets. Patients receiving care in or from the emergency department who are without financial resources may be eligible for the FAP if they are unemployed or self-employed and cannot provide income an income tax statement, are indigent without access to the required application documentation may still be eligible for financial assistance.
H. Catastrophic
Beebe Health will consider the total medical expenses faced by an uninsured family and the family’s ability to pay for those expenses, and offer greater assistance, when possible, to those individuals or families facing catastrophic medical expenses.
- Patients, whose patient responsibility after all eligible discounts is greater than 25% of the gross annual family income, may be eligible for Catastrophic financial assistance and awarded 100% on open balances not currently in bad debt.
I. Appeals
Responsible parties may appeal financial assistance determination by providing additional information, such as insurance verification or an explanation of extenuating circumstances to Patient Accounts within 30 days of receiving notification of a denied application.
J. Financial Assistance Balance Approval Guidelines
Approvals will be as follows:
- Balances up to $5,001-$25,000 will be approved by the Senior/Supervisor of Public Benefits
- Balances between $25,001.00 to $50,000.00 will be approved by the Manager of Public Benefits.
- Balances between $50,001.00 and above will be approved by the Director of Public Benefits.
Next Steps
Before you complete the application below, please verify you have everything using one of these checklists:
- Download a short summary of the Financial Assistance Policy
- Download the Financial Assistance Application (English)
- Haga clic aquí para descargar la solicitud de asistencia financiera en Español
Questions? Please email [email protected]