SUBJECT: Financial assistance for patients who cannot afford to pay
PURPOSE: To assist patients in receiving services if they meet the financial requirements of the National Poverty Level or are financially indigent.
SCOPE: All eligible patients
POLICY: Patients who are unable to pay for services at Sand Lake Surgery Center may request an estimate of charges for a needed procedure and an assessment of their eligibility for financial assistance.
PROCEDURE:
- All copays and deductibles are due prior to surgery at Sand Lake Surgery Center
- If the patient is unable to pay this amount, Care Credit is available and allows monthly payments to be made. For the application process, go to CareCredit.com.
- If the patient requests evaluation for further assistance,
- The patient will be asked to provide a copy of their Federal Income Tax Statement and a current payroll stub.
- The National Poverty Level Sliding Scale will be reviewed to determine where the patient’s income level falls
- If the patient meets or is below the gross income amount of the national poverty level, the appropriate write-off is made applicable to the procedure charge amount.
- Collections Procedure
- A statement of account will be sent every month for three months.
- After 90 days a final statement will be sent allowing 10 days to pay. If no payment is received after the 10 days have passed, the account will be sent to collections.