Financial Assistance Policy

Stony Point Surgery Center and West Creek Surgery Center
Charitable Care and Financial Assistance Policy

Stony Point Surgery Center's/West Creek Surgery Center’s mission is to provide the best care to every patient every day.  As part of that commitment, SPSC/WCSC appropriately serves patients in difficult financial circumstances and offers financial assistance to those who have an established need to receive emergency or medically necessary medical services. SPSC's/WCSC’s policy is to provide emergency care to stabilize patients, regardless of their ability to pay. Non-emergent patients requiring charity care consideration should be reviewed and approved before services are provided. Emergency and medically necessary care will not be denied for non-payment on prior outstanding amounts, however, the organization may require the establishment of a payment plan for non-urgent medically necessary care. 

This policy serves to establish and ensure a fair and consistent method for the review and completion of requests for charitable medical care to our patients in need. This policy applies to bills owed to both Stony Point Surgery Center/West Creek Surgery Center Anesthesia including the anesthesiologist and the CRNA, but does not include any other providers. To access a list of the providers that operate at Stony Point Surgery Center/West Creek Surgery Center please visit http://www.stonypointsc.com/surgery/surgeon-list.   

Patients who want to apply for financial assistance or who have been identified as potentially eligible for financial assistance will be informed of the application process either before receiving services if the facts suggest potential eligibility or after the billing and collection process has begun. Patients will receive information relating to SPSC’s/WCSC's financial assistance policy prior to discharge from the facility. The application process may be waived or suspended due to medical necessity, including timing and urgency of care. Patients or their representative can obtain a financial assistance application by mail by contacting Patient Account Services at 804-775-4525, from our website http://www.stonypointsc.com/surgery/financial-assistance-policy, or in person from the center located at 8700 Stony Point Parkway Suite 100 Richmond, Va. 23235.  All patients/guarantors who receive a Financial Statement application must complete and return the application to the same address, along with the following documents that serve as the minimum information necessary to process an application for financial assistance: 

 

SPSC/WCSC reserves the right to reverse financial assistance adjustments and pursue appropriate reimbursement or collections in circumstances where additional information becomes available or instances where erroneous or fraudulent information had been presented by the applicant. 

Financial Assistance will not be denied based on an applicant's failure to provide information or documentation beyond the documents listed above.  If an applicant does not have any or all of the listed documents, he or she may call Patient Account Services at 804-775-4525 and discuss the availability of financial assistance.

In order to expedite and award financial assistance in a timely manner the organization encourages patients to return the application and applicable documents in a reasonable time period. SPSC/WCSC reserves the right to deny applications submitted after 240 days from the date that the facility provides the first post-discharge billing statement for care.

The amount that a patient is expected to pay and the amount of financial assistance offered depends on the patient's income. The Federal Income Poverty Guidelines will be used in determining the amount of the write off and the amount charged to patients, if any, after an adjustment. Amounts charged for emergency and medically necessary medical services to patients eligible for Financial Assistance will not be more than the amount billed to individuals with Medicare covering such care.

Partial and/or full charity care will be granted based on the individual’s ability to pay the bill. Eligible individuals include those patients that do or do not have insurance with incomes that are up to 300% of the federal poverty level.  Individuals eligible for financial assistance will not be charged more than what would be the expected Medicare reimbursement rate for the service provided. The discounts below are provided against the base Medicare Reimbursement rate for the services provided.

200% of Poverty Level

250% of Poverty Level

300% of Poverty Level

Family Size

Poverty Level Base Income

Income Rate

100% Discount

50% Discount

25% Discount

1

$11,670.00 

Annual 

$23,340.00 

$29,175.00 

$35,010.00 

1

$972.50 

Monthly

$1,945.00 

$2,431.25 

$2,917.50 

2

$15,730.00 

Annual 

$31,460.00 

$39,325.00 

$47,190.00 

2

$1,310.83 

Monthly

$2,621.67 

$3,277.08 

$3,932.49 

3

$19,790.00 

Annual 

$39,580.00 

$49,475.00 

$59,370.00 

3

$1,649.17 

Monthly

$3,298.33 

$4,122.93 

$4,947.51 

4

$23,850.00 

Annual 

$47,700.00 

$59,625.00 

$71,550.00 

4

$1,987.50 

Monthly

$3,975.00 

$4,968.75 

$5,962.50 

5

$27,910.00 

Annual 

$55,820.00 

$69,775.00 

$83,730.00 

5

$2,325.83 

Monthly

$4,651.67 

$5,814.58 

$6,977.49 

6

$31,970.00 

Annual 

$63,940.00 

$79,925.00 

$95,910.00 

6

$2,664.17 

Monthly

$5,328.33 

$6,660.43 

$7,992.51 

A Business Office Representative will review all returned Financial Assistance Application for completeness. The Business Office Representative will consult the Financial Assistance authorization guidelines and present the Financial Assistance Application to the Director of Patient Financial Services for consideration. Once a decision has been made for financial assistance, notification is sent to each applicant advising them of the decision. 

In the event that the applicant submits an incomplete financial assistance application prior to 240 days from the date that the facility provides the first post-discharge billing statement for care, the applicant will be notified of the missing information and WCSC and SPSC will allow the individual 10 business days to provide the missing information prior to the organization to making its final determination. For incomplete applications submitted in excess of 240 days from the date that the facility provides the first post-discharge billing statement for care, SPSC/WCSC reserves the right to reject such incomplete application.   

SPSC/WCSC will make reasonable efforts in notifying patients about its financial assistance policy throughout the billing and collection process. During the initial 120 days from the date that the facility provides the first post-discharge billing statement for care SPSC/WCSC will notify the patient about the financial assistance policy. This notification will occur via the billing statements which will contain applicable information about where to receive information and the application relating to financial assistance. The patient will receive a minimum of three written notifications, as described above, within the first 120 days from the date that the facility provides the first post-discharge billing statement for care. Additionally, SPSC/WCSC will attempt to verbally notify the patient of the financial assistance policy during this period. 

If the patient has not submitted a financial assistance application within 120 days from the date that the facility provides the first post-discharge billing statement for care, the Director of Financial Services will determine the appropriate next steps for collection on the account, which could include referring the account to an outside collection agency.
However, SPSC/WCSC will not engage in any extraordinary collection actions before it makes a reasonable effort to determine whether a patient is eligible for financial assistance under this Policy, and in no circumstances, will SPSC undertake any extraordinary collection actions within 120 days from the date that the facility provides the first post-discharge billing statement for care. 

If the financial assistance application has been denied for any reason listed above and there is non-payment of the bill after 120 days, the patient will be notified 30 days in advance (to assignment) and the account will be assigned to either a collection agency or a law firm for further collection action. This could result in collection agency fees including interest, judgments, garnishments of bank accounts and wages, credit reporting, liens and interrogatories.

In the event that the patient applies for financial assistance after the account has been placed in collections, but before the close of the 240 day application period, and the patient is determined to be eligible for financial assistance, collection efforts will cease on the eligible portion of the bill.  The organization or its third party representative will work towards reversing any adverse impact that the extraordinary collection may have caused. Additionally, any amount paid by the patient in excess of the patients’ obligation after the discount will be subsequently refunded.

 

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