Payment liability shifts from payers to patients from time to time, making it difficult for hospitals to collect the entire payments promptly. The patients face their turn of hardship through higher deductibles. Hospitals will write patients off if they identify a patient’s inability to pay before delivering services. Thus, if you are a patient looking for an important medical treatment but finding it difficult to bear the expense, seek charity care. Charity screening solution is a mandatory procedure in USA health care to identify and offer either free or discounted medical help for people who cannot afford their hospital bills.
How Do Hospital Charity Programs Work?
Charity screening solution identifies ideal candidates in need of medical help and renders charity care to patients who do not have sufficient income. Patients who have health insurance can also qualify for charity care. There is a general rule by which non-profit hospitals should provide charity by the Affordable Care Act (ACA) aligning with the Internal Revenue Service (IRS) to maintain its non-profit status. But the IRS permits the hospital to make its own set of rules on who qualifies for charity care. Some states in the USA have laws passed making various health care providers provide charity care. Certain factors influencing the patient’s eligibility for charity care are:
Influence of Charity Care in Healthcare Industry
According to a survey, many patients are anxious about their medical expenses thinking that they might not be able to afford them. For a few, the uncompensated care costs like bad debts would have already accumulated to a huge sum. Although a majority of the patient population is eligible for charity care, most of them are unaware of it. Thus, they end up not visiting a doctor. Charity screening solution plays a significant role here. Healthcare providers in the USA use tools & techniques to assess patients to determine their eligibility to receive financial support. By analyzing their backgrounds, the amount is decided and will vary based on the policies, non-profit status, and hospital location.
How Charity Screening Solutions Work?
While determining a patient’s financial background, the best course of support anyone can offer is paying their bills. Charity screening solution makes this happen by first analyzing patients’ records with an automated process. The initial screening finds out who qualifies for a charity care program. Depending on their condition, discounted or free healthcare services are provided to cover their medical debts. Thus, the charity screening solutions improve the financial assistance footprint of the healthcare providers in every state of the USA. The techniques help providers deliver fair and consistent evaluations for patients.
Also Read: A Quick Reference Guide on Hospital Financial Assistance
The process of analyzing a patient’s eligibility is complex as the healthcare providers must go through an ocean of information. The factors that are to be considered in every charity screening procedure are:
The level of financial support provided to a patient varies from one state to another in the USA. The charity screening solution uses tools that also check credit as a part of the eligibility assessment process. However, more and more providers are looking forward to automation and AI to access wider and more versatile data and gain quick and precise results. The screening process follows and pertains to the available public records and includes W-2s, pay stubs, social security details, tax returns, and general social service documentation.
Charity screening is a key tool for providers as it finds more coverage for a greater volume of patients. The charity screening solution is fair, ensuring legal compliance and improving patient experience. Charity screening had gained great importance before the pandemic. However, the fallout from COVID-19 is pushing the providers further to pursue comprehensive solutions to assess eligibility and augment patients’ ability. Many people have lost their jobs after the pandemic in the USA, and this has led to a greater population of people losing their health insurance coverage. Once the quarantine restrictions are completely lifted, unemployed people will need more understanding and help to afford healthcare. Thus, charity care allows meeting the financial challenges of patients and helps providers secure financial help after identifying the right patients.
In the USA, there is a law that non-profit hospitals must provide information about their charity care program within their premises in various ways. Though each hospital handles it in ways that are comfortable for them, a few effective methods are:
A few hospitals make an extra effort to assess the patient’s eligibility by providing a charity screening solution when they check-in. In contrast, certain hospitals stick to the simple procedure of just including information about charitable care in areas highly accessed by patients. Some providers offer assistance to patients without insurance, and a few others offer only partial assistance to patients with insurance. The basic information any hospital will ask the patient to submit to determine their eligibility for charity care includes:
The approval process for charity care will take somewhere between two to six weeks. It depends on the provider’s backlog of applications. Once the application gets approved or denied, the applicant will receive a letter from the provider. In the event of approval, the amount of money that the charity care covers will be refunded, and when denied, the letter will explain how to appeal further. As the application process is not as easy as it sounds, some people prefer opting for traditional application processes. Though the traditional application requires an in-depth charity screening solution procedure with proper paper documentation to state the financial condition, it further requires:
More automated techniques with the latest technologies are emerging to help the providers manage and handle the process efficiently. Mobile apps are one such effective solution used in the USA to complete charity care applications in the comfort of the patient’s home.
What to Look for in a Charity Screening Solution?
The charity screening solution must provide full population coverage. You should choose the ones that are calibrated to emulate entirely documented approvals. However, it is basic in the USA that individuals learn the ways on how an effective charity screening solution affects patient experience with credit checks. Therefore, you must rely on data sources and avoid using soft or hard credit hits. If the vendor you work with is either inexperienced or ill-equipped, the integration procedure may be disruptive or tricky to the daily operations. Thus, to confirm seamless integration, always look for a proven and seamless history backed by strong customer support.
The Takeaway
You must be well aware that there is nothing to fear while receiving a high medical bill with the above information. There are various resources to help, and CoverMe is a leading front end RCM solution provider in the USA to offer the best financial assistance.
