Financial Policy

POLICIES:
Non-discrimination of Services
Emergent medical services will be provided regardless of patient’s ability to pay.

Payment Responsibility
KDMC expects payment at time of service. Generally, KDMC will ask for unmet deductibles and estimated out-ofpocket co-payment amounts that the patient or patient’s guarantor will owe. KDMC may also ask the patient to settle any outstanding accounts that may be designated bad debt. KDMC’s Patient Financial Services Department will bill adequate, verified, insurance plans for its patients if the patient provides the required insurance
information within timely filing requirements and signs an assignment of benefits statement. The patient or legal representative is ultimately responsible for all charges incurred.

All estimated deductibles and co-insurance amounts would be requested at time of service by means of cash, check, bank draft, or credit card. Extended payment arrangements for patients requiring extra time to resolve self-pay portions must be established at time of service and meet established payment plans as set in current Medical Center Policy.

Payment Agreements
When a balance due cannot be paid at the time of service a payment agreement will be required in order to approve payment arrangements. Payment arrangements in general should not extend beyond a12month time frame, however, KDMC will make exceptions when the amounts due are too large to be met when considering the patient’s ability to meet the obligation.

Emergency Services
Medical services will be provided regardless of the patient’s ability to pay; however, the Medical Center shall pursue financial arrangements with the family or patient once the Emergency condition has passed and before the patient is discharged. Emergency patients will be triaged to determine the extent and severity of the emergency and medically screened in accordance with the Emergency Treatment and Active Labor Act (EMTALA).
Reasonable registration procedures can continue as long as they do not delay Medical Screening.

Uninsured Patients/Non-Covered Services
Payments for all charges, which are not covered by insurance, are due and payable at the time of services or upon discharge. If necessary, suitable payment plans may be established. A preadmission deposit of 10% of estimated charges may be required for services that are elective in nature or are not emergent. In the event patients are unable to pay KDMC will work with the patient to determine if they are eligible for government
assisted programs or if they qualify for charity care.

Preregistration Program

• Preadmission information may be requested prior to scheduled admissions and outpatient service.
• Patients may be required to make payment of the anticipated charges for elective, uninsured services prior to the date services are to be rendered.

Inpatient Visits
If adequate financial arrangements were not made at time of admission, the Patient Financial Services staff will visit the patient or family prior to discharge for payment resolution.

Verification of Information
All information given regarding the ability to pay, third-party insurance, employment, etc. will be subject to verification including credit worthiness.

Unpaid Insurance Balances
Although the Medical Center will make every effort to collect assigned third party benefits from the third- party payer, the Medical Center does reserve the right to involve patients at some point. In the event that the ThirdParty refuses to make a disposition of the claim, the patient may be requested to make full payment of unpaid balances for non-government or non-contractual payers.

Third-Party Litigation
King’s Daughters Medical Center may place a hospital lien on a patient’s third-party liability claim with the exception of verified Worker’s Compensation Claims, and in States where “No Fault” automobile insurance prevails. Medicare Secondary Payor (MSP) requirements will be followed as outlined in the Medicare Billing section of Publication 10. State requirements regarding Medical Assistance will be followed.

Prior Unpaid Accounts
Prior to providing elective and any non-emergency services, the Medical Center will request and receive the payment of prior outstanding accounts, including bad debts, or have specific payment arrangements approved by the Patient Financial Services Office. If arrangements cannot be established with patient, after discussion with physician, the services may not be rendered until satisfactory payment agreement can be established.

Management of Self-Pay Accounts
Accounts which cannot be collected by King’s Daughters Medical Center after normal in-house collection procedures may be referred to a collection agency, magistrate or attorney for further collection action at the discretion of the Director of Patient Financial Services or designee.

Legal action
If deemed appropriate by the Chief Financial Officer or Director of Patient Financial Services King’s Daughters Medical Center may take legal action, including garnishment of wages or the execution of a lien on personal property, in order to collect balances owed. KDMC will not force a sale, attempt repossession or take other proactive measures when a property lien is employed.

Third-Party Audits
King’s Daughters Medical Center recognizes the need for audits of insurance claims by insurance companies or their contracted audit firms. The Medical Center will cooperate in making available required information, but will require all audits be done on sight and that the insurance company pay 95% of the estimated insurance liability due before any audit is done.

Discounts
For Insured Patients:
The Medical Center will offer a 30% prompt pay discount on any out of pocket cost, excluding an insurance deductible, provided the payment is made at the time of service.

For Ministers:
A 30% discount (excluding Medicare) will be given for full-time licensed or ordained Ministers on their patient portion only. To qualify for this discount the minister must present proof to the Patient Financial Services Department that they work full-time as a minister and meet the Payment Guidelines within this policy. The salary resulting from their Ministry position must be the primary source of income for the Minister and all qualified
dependents.

For Uninsured Patients:
KDMC realizes that there are a large number of uninsured in the community that can obtain no insurance or have chosen to have no insurance. So that these individuals can receive a discount similar to KDMC’s major private insurance companies, we will offer a 30% prompt pay discount if balance due is paid in full within 30 days of service.

Charity Allowances
Refer to the Financial Assistance Policy.

Refunds
Overpayments will be refunded to the appropriate party – normally the insurance company or guarantor. Patients’ refunds will not be processed until all active or past due accounts are paid in full. Refunds less than the Medical Center’s small balance write-off allowance will not be refunded unless specifically requested by the patient/guarantor or insurance company.

Small Balance
It is the policy of King’s Daughters Medical Center that all accounts with a balance of $19.99 or lower will not be billed to the patient and will be adjusted off each patient’s account monthly.

Payment Guidelines
Patient Financial Services employees have the authority to arrange terms for a six month period. If, for any reason a patient cannot pay within the six month time, the patient will be referred to a Financial Counselor who has the authority to set arrangements up to twelve months. Only the Director of Patient Financial Services or Supervisor will have the authority to set limits beyond twelve months.