FINANCIAL POLICY
PURPOSE
Rural Health Resources of Jackson County, Inc. (RHR) is a not-for-profit corporation established under laws of the State of Kansas to provide for the healthcare needs of persons who reside in Holton, Kansas and surrounding communities that include the counties of Atchison, Brown, Jackson, Jefferson, Nemaha, Pottawatomie and Shawnee. RHR qualifies as a tax-exempt organization under section 501c3 of the Internal Revenue Code. In order to carry out its mission, RHR must receive adequate and timely reimbursement for goods and services provided.
The purpose of this policy is to ensure that RHR is fairly and adequately compensated for services provided; to ensure the efficient and effective utilization of the fiscal and capital resources of RHR; to ensure that fiscal operations are in accordance with generally accepted accounting principles and business practices; consistent with the regulations which govern the operation of healthcare facilities; and consistent with operating budget approved by the RHR Board of Directors.
POLICY
As a participant in the Medicaid and Medicare programs Rural Health Resources of Jackson County, Inc. (RHR) shall not deny healthcare services to anyone because of an inability to pay for services. As a charitable organization the RHR Board has a written policy that provides a charitable healthcare discount for services provided to indigent patients. (See RHR Charity Care policy for additional information.)
In order to carry out its mission and to provide cost effective healthcare services; reduce costly billing and accounting overhead costs; it shall be the policy of RHR to require payment for services at the time of service in accordance with the following financial standards:
1. For the convenience of our patients RHR shall accept cash, checks and credit cards for payment.
2. For the convenience of our patients RHR shall accept direct assignment of insurance benefits, including discounts for services, which may be, negotiated between RHR and third party payers as a condition of insurance assignment. RHR business office staff shall assist a patient in evaluating third party coverage for services provided by RHR. This acceptance does not relieve the patient of the ultimate responsibility to pay for services received; to pay deductibles and co-payments at or before the time of service; or to pay for services not covered by third party benefit plans.
3. For the convenience of our patients RHR shall participate as a provider in the Kansas Medicaid Program, subject to the CMS conditions of participation and the State of Kansas Medicaid Rules and Regulations and shall accept direct assignment of benefits. RHR accepts assignment of Medicaid benefits as a convenience to our patients; this acceptance does not relieve the patient of the ultimate responsibility to pay for services received; to pay deductibles and co-payments at or before the time of service; or to pay for services not covered by third party benefit plans.
4. For the convenience of our patients RHR shall participate as a provider in the Medicare Program, subject to the CMS conditions of participation and shall accept direct assignment of benefits. RHR accepts assignment of Medicare benefits as a convenience to our patients; this acceptance does not relieve the patient of the ultimate responsibility to pay for services received; to pay deductibles and co-payments at or before the time of service; or to pay for services not covered by third party benefit plans.
5. For Patients who have no insurance and are responsible for full payment on their account, will meet with the Patient Financial Services Manager to make a deposit that is agreeable to both parties before any procedure will be scheduled.
6. The RHR Patient Payment Policy is divided into the following categories and is based on the balance due from the patient following applicable discounts as may be provided by this policy:
$5.00 to $100.00: The account balance is due and payable within thirty (30) days from the date of billing.
$5.00 to $100.00: The account balance is due and payable within thirty (30) days from the date of billing.$101.00 to $200.00: The account balance is due and payable over a three (3) month period, with three (3) equal monthly payments. All payment plans shall be defined in writing and signed by the Patient Financial Services Manager and the responsible party.
$201.00 to $500.00: The account balance is due and payable over a six (6) month period, with six (6) equal monthly payments. All payment plans shall be defined in writing and signed by the Patient Financial Services Manager and the responsible party.
$501.00 to $1,000.00: The account balance is due and payable over a twelve (12) month period, with twelve (12) equal monthly payments. All payment plans shall be defined in writing and signed by the Patient Financial Services Manager and the responsible party.
$1,001.00 to $3,000.00: The account balance is due and payable over an eighteen (18) month period, with eighteen (18) equal monthly payments. All payment plans shall be defined in writing and signed by the Patient Financial Services Manager and the responsible party.
$3,001.00 to $5,000.00: The account balance is due and payable over a twenty-four (24) month period, with twenty-four (24) equal monthly payments. All payment plans shall be defined in writing and signed by the Patient Financial Services Manager and the responsible party.
7. A "Prompt Pay" discount may also be considered upon the request of the Patient/Guarantor. All "Prompt Pay" discounts shall be approved and authorized by the Chief Executive Officer and/or the Patient Financial Services Manager.
8. Consistent with acceptable community business standards of practice, RHR provides a monthly guarantor statement for services provided by RHR. These guarantor statements provide a summary of charges but not an itemized detail of charges. RHR patients upon request to the RHR business office or Patient Financial Services Manager shall be entitled to an itemized statement of charges; there shall be no charge to the patient and/or guarantor for this initial statement.
9. An account shall be considered past due if RHR has not received any payments on the account; or a patient has made a payment to RHR less than the amount agreed to in a written payment plan. Accounts more than 120 days past due shall be subject to immediate collection proceedings in accordance with the following standards:
a) The Patient Financial Services Manager shall ensure that at least three (3) attempts are made to contact the responsible party (guarantor) in an effort to bring the account current, prior to referring the account to a collection agency. This information shall be documented in RHR business records. A current account shall be defined as all accounts payable due to RHR by the responsible party, have been paid in full as defined and described in this policy.
b) In the event the responsible party is unable or unwilling to bring the account current, the Patient Financial Services Manager shall take such legal action as permitted by law to recover the funds due to RHR.
10. The Chief Executive Officer (or designee) shall be authorized to write-off or reduce all or part of any balance due for the cause of failure of performance by RHR. The cause for action and the balance written off shall be documented in writing in the patient's business record. Account balances may not be written-off or reduced due to inability to pay in addition to that authorized by the RHR Charity Care Policy approved by the RHR Board.
The RHR Patient Financial Services Manager shall be responsible for ensuring that both written and verbal notification is provided to RHR patients of this financial policy. When at all possible this information shall be provided to the patient prior to providing goods or services. Compliance of this requirement shall be documented in writing in the patient medical record.
RHR staff found to be in violation of this policy shall be subject to disciplinary action including dismissal from employment.
PROCEDURE
The Patient Financial Services Manager shall be responsible for developing forms to inform RHR patients concerning this financial policy. The patient and/or responsible party and the RHR staff member informing the patient shall sign the form. The original shall be filed in the patient's medical record and a copy shall be given to the patient.
The Patient Financial Services Manager must review and approve all payment plans, subject to the terms and conditions of this policy.