Financial Assistance FAQs
What is "financial assistance"?
It is the amount the patient does not have to pay based on the patient's family size, financial situation and the Federal Poverty Guidelines (FPG). The discount amount is calculated as a percentage of charges. Baptist offers financial assistance to uninsured and underinsured patients.
How do I apply for financial assistance?
Baptist has two financial assistance policies specifically for the uninsured and the medically underinsured. Both the Baptist Hospital Financial Assistance Policy (Hosp-FAP) and the Baptist Financial Assistance Policy for Professional Charges (Pro-FAP) detail the process for applying for financial assistance. Patients complete a Financial Assistance Application and submit the application, as well as all required financial documents to the billing office where services were received.
What is the difference between the two financial assistance policies?
True to their name, the Hosp-FAP outlines the Baptist program for granting financial assistance for hospital and certain hospital-based charges. The Pro-FAP outlines the program for granting financial assistance on charges stemming from physicians and other professional services.
The last time I was approved, I received the same discount at all Baptist locations. Why are the discounts different now?
As of August 31, 2017, the discount percentages for the hospital and physician charges have been separated into two policies.
The biggest difference for BMHCC/BMH/BMG (etc.) facilities is the switch to a separate discount percentage table for professional services. These services must also be medically necessary and patients only have 10 days from the date of the first billing statement to apply for assistance under the Pro-FAP.
The biggest change for the Mississippi Baptist facilities is the method for qualifying patients for assistance. Patients will no longer be processed for assistance without providing a charity application. The discount determination switched from partially to completely income-based.
Does the discount cover all of my charges?
No, Baptist financial assistance only covers charges by participating Baptist facilities and providers. In some cases, patients may receive separate bills for non-covered services; example of which include outside labs and non-participating physicians, among others. Use the BMHCC website link for the list of participating providers.
What is a self-pay minimum discount?
The self-pay minimum discount is a flat rate discount amount applied to all applicable accounts for Hosp-FAP eligible patients. Patients determined to be eligible for financial assistance for emergency and other medically necessary care will not be charged more than the amounts generally billed (AGB) to patients with insurance. If the patient is unable or unwilling to provide the necessary supporting documentation required to determine eligibility per the Hosp-FAP, the patient will receive this flat discount rate. Please note that the actual discount percentage will vary between facilities.
Why isn't the self-pay minimum discount the same at all of the Baptist locations?
The self-pay minimum discount is a flat-rate discount amount given to all uninsured patients. The minimum discount rate may slightly vary between different Baptist facilities due to geographic and reimbursement factors. As Baptist operates in three different states, discounts are impacted by not only federal guidelines, but also state and county laws.
Do I have to apply for the self-pay minimum discount for charges from the Hosp-FAP eligible providers?
No, Hosp-FAP eligible, self-pay patients will receive this discount automatically unless the patient or services received are specifically excluded from the Baptist FAPs. There is not a self-pay minimum discount for the Pro-FAP provider charges.
Why isn't the self-pay minimum discount the same at all of the Baptist locations?
The self-pay minimum discount is a flat-rate discount amount given to uninsured patients for hospital and/or certain hospital-based charges. The minimum discount rate will vary slightly between different Baptist facilities due to geographic and reimbursement factors. The discounts are annually recalculated using charge and payment data; the minimum discount table is updated every October 1st. Baptist operates in three different states; discounts are impacted by not only federal guidelines, but also state and county laws.
What are "hospital-based charges"?
Hospital-based charges are considered technical charges. Examples of which include charges for the use of equipment, facilities, non-physician medical staff, and supplies in areas such as hospitals, skilled nursing facilities and other institutions for outpatient and inpatient services. Rural health centers, hospital-based physician clinics, the Oxford Diagnostics Center and the Reynolds Hospice House are considered hospital-based facilities and are process under the Baptist Hosp-FAP.
How do I know if the place I received treatment is part of the Hosp-FAP or the Pro-FAP?
The lists of providers participating in the Hosp-FAP and the Pro-FAP are included on the BMHCC website. A list of non-participating providers is also included on the website.
Why are some clinics and doctor's offices on the list of Hosp-FAP providers and others are included on the Pro-FAP list?
The fact that some clinics are included in the Hosp-FAP, instead of the Pro-FAP is somewhat confusing. The lists are determined by the corporate billing entity for each facility. Please reference the BMHCC website for up-to-date facility classifications.
I had to go to the emergency room after a car wreck. I do not have insurance. Why can't I get financial assistance?
Charges generated as the result of a motor vehicle accident are generally excluded from Baptist FAP discounts. However, if the patient provides proof that there is no third party insurance coverage for this incident, then the patient is eligible to apply for financial assistance. Both policies contain a short list of excluded situations and/or procedures.
Why do you need to know who lives in our house?
The discount determinations are based on the FPG. The FPG uses family size to determine the income threshold percentages. Per the Baptist FAPs, "a family is a group of two or more persons related by birth, marriage, or adoption who live together; all such related persons are considered as members of one family. For instance, if an older married couple, their daughter, her husband, two children and the older couple's nephew all lived in the same house or apartment; they would be considered members of a single family and the household size or family unit would be seven."
What documents are needed to determine if I qualify for financial assistance?
The FAP states that the following documents can be used to determine the family income.
- Pay stubs for the last three months
- Income tax return for the previous year
- W2 Form for the previous year
- State/Federal assistance documents
- Bank statements for the last 3 months
- Legal documents including divorce decrees and/or child support and alimony
- Retirement and pension statements
The most recent income information is given priority in determining financial status. Documentation supporting the income of all family members must be provided. Gross income is used for determining the patient's financial status. Noncash benefits like food stamps are not counted as income, although statements with income determination from these sources can be used to support the FAP income calculations.
I am paid in cash and do not have any of the financial documents on the approved list in the policy. Can I have my employer write a letter that shows he pays me $100 every week?
No, letters cannot be used to substantiate income. If patients cannot provide any of the sources listed in the FAP as acceptable documentation, they are not eligible for additional FAP assistance unless the uninsured patient's charges were for emergency or medically necessary hospital charges, then a self-pay minimum discount will be applied to those charges.
Is educational financial aid considered income and included in the determination?
Financial aid that a student is receiving is considered income and is counted in the income determination.
How long is my financial assistance discount good for?
Once approved, the financial assistance discount percentage is good for 90 days. The coverage dates will be listed on the approval letter. After the discount period has expired, the patient will need to re-apply.
If I am denied for additional financial assistance, when can I reapply?
Patients who did not qualify for discounted care may reapply after 90 days or if they have experienced a material change in family or income status.
Do I have to apply at each different Baptist hospital that I go to?
No, once approved for a Baptist FAP discount, that discount is good for emergency and/or medically necessary care at any of our participating facilities. The best practice is to show your assistance approval letter to the registration employee prior to receiving treatment.
The hospital says I do not have a charity discount, but I was approved for a 100% discount at my doctor's office. Why do I have to apply again?
Unless the discount period has expired, you do not have to apply again. You can take your assistance approval letter to any of the other participating facilities and show it to the registration person. Remember the discount is only good on emergency and medically necessary care and the actual discount percentage will vary based on the location the services were received. If you have already received the service and your discount was not applied, please call the Business Office number listed on your bill and they will work with you to resolve.