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FINANCIAL ASSISTANCE PROGRAMS
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At the core of what we do is a mission to serve the healthcare needs of all people in our community
24 hours a day, 7 days a week regardless of their ability to pay. Prince William Hospital provides care based on the following principles:
| | Treat all patients fairly, with dignity, respect and compassion. | | | Serve the emergency healthcare needs of everyone. | | | Assist patients who cannot pay for part or all of their care. | | | Coordinate needed financial assistance for some patients with broader fiscal responsibilities in order to keep the hospital open and viable. |
The following guidelines are offered to assist Prince William Hospital patients who cannot afford the medical care they have received at Prince William Hospital.
Communication
The Hospital will:
| | Provide financial counseling to patients regarding the costs of their medical services. For assistance, call (703) 369-8020 from 8:00 a.m. to 5:00 p.m. Monday through Friday. | | | Provide financial counseling to patients regarding the costs of their medical services. | | | Will respond promptly to patients' questions about their bills and to requests for financial assistance. | | | Use a billing process that is clear, concise, correct, and patient friendly. |
Helping Patients Qualify for Coverage
The Hospital will:
| | Make available information on hospital-based charity care policies and other known programs of financial assistance. | | | Assist uninsured patients who apply for financial assistance programs such as Medicaid and the Virginia State and Local Hospital Fund through use of an outside vendor who is sensitive to cultural and language differences in our community. |
Ensure Hospital Charity Care Policies are Applied Accurately and Consistently
The Hospital will ensure that all:
| | Written policies for assisting patients with limited means are applied consistently. | | | Staff members who work closely with patients such as those working in patient registration, admitting, financial counseling, customer service, billing and collections are educated about hospital billing, financial assistance and collection policies and practices. |
Making Care More Affordable for Patients with Limited Means
Charity care is available to all patients who apply and also meet the charity care criteria. Prince William Hospital (PWH) offers the following financial assistance programs:
| | Virginia Indigent Trust - The hospital participates in the Virginia Indigent Trust, which is a state-sponsored program offering charity care equal to 100% of billed charges if the patient financial condition is determined to be within 100% of the federal poverty guidelines.
| | | PWH Charity Care - The hospital offers a charity care discount, based on a sliding scale, for patients whose total family income ranges from 0% to 400% of the federal poverty guidelines.
Total family income is compared with current federal poverty guidelines. (Federal Poverty Guidelines Exhibit A). If the patient's income falls below 400% of the guidelines, the patient would be eligible for some level of patient financial assistance. The sliding fee scale used to calculate the amount of the financial assistance. The federal poverty guidelines can be found on the government website www.aspe.hhs.gov/poverty.
| | | Using, the annual revision of the Federal Poverty Guidelines as published by the Department of Health and Human Services each February the hospital will update the sliding fee table each year.
| | | Persons eligible for assistance will be responsible for a portion of billed charges in accordance with the Federal Poverty Guidelines Sliding Fee Schedule. |
The Annual Family Income is based on the Federal Poverty Guidelines, which will determine the percentage of financial assistance the patient may receive.
Financial Assistance Plans
Self-Pay Uninsured Discount Plan:
| | Self-Pay discount — 35% off gross charges. | | | If a balance is remaining on the account, the Financial Counselor will collect a down payment and set up a payment plan for the remaining balance. | | | Payment plans will not be effective until the initial payment is received. |
Health Savings Accounts (HAS) Discount Plan:
| | Self-Pay discount — 35% off gross charges. | | | If a balance is remaining on the account, the Financial Counselor will collect a down payment and set up a payment plan for the remaining balance. | | | Payment plans will not be effective until the initial payment is received. |
Underinsured Discount Plan:
| | Self-Pay discount — 35% off the patients' responsibility. | | | If a balance is remaining on the account, the Financial Counselor will collect a down payment and set up a payment plan for the remaining balance. | | | Payment plans will not be effective until the initial payment is received. |
Exhausted Policy Limits:
| | Patients who have exhausted policy limits are eligible for financial assistance plan offered by Prince William Hospital. | | | Remaining account balances after policy limits are exhausted are considered uninsured. | | | Payment plans will not be effective until the initial payment is received. |
Eligibility and Elective Services
| | Case by case reviews may occur if applicable. | | | Uninsured accounts are eligible for discounts for the previous six months and for future care for the next six months based on the receipt of the completed application. | | | Discounts for underinsured and Health Savings Accounts for co-pays and deductibles are not eligible and will be applied on an account-by-account basis. | | | Patients who desire elective services but are uninsured or have a large insurance deductible will be referred to a financial counselor to discuss financial arrangements. | | | To be considered for a discount under the charity care policy, an uninsured person must cooperate with the hospital to provide the information and documentation necessary to determine eligibility or they may be subject to normal collection practices. | | | All required documentation must be provided within 30 days of application for financial assistance. |
Ensure Fair Billing and Collection Practices
| | The hospital ensures that the collections of patient accounts are pursued fairly and consistently reflect the public's high expectation of hospitals. | | | The hospital defines the standards and scope of practices used by outside collection agencies acting on its behalf. | | | Accounts assigned to a collection agency and later found to meet charity care criteria may be returned to the hospital and considered as charity care with no negative impact on the patient. Charity application approval is retrospectively valid for six months. |
Glossary of Terms: Key Abbreviations and Terms Defined
Charity Care: Charity Care discounts based on a sliding scale for patients whose income ranges are
between 100% and 400% of the current Federal Poverty Guidelines.
CMS: Centers for Medicare and Medicaid Services
Federal Poverty Guidelines: Current Federal Poverty Guidelines established by the U.S. Government
and published in the Federal Register and updated annually by the Department of Health and Human
Services.
Financial Counselor: Employees of Prince William Hospital whose primary responsibility is to assist
the patient in understanding their financial options.
Gross Charges: The amount the hospital charges for the services provided.
Health Savings Account: The Health Savings Account (HSA) is a tax-advantaged savings plan
(a financial account with various restrictions) available to taxpayers in the United States to cover current
and future medical expenses.
Hospital Charity Care Program: Prince William Hospital-funded charity care program.
Medicaid: State-funded healthcare program for the residents living in the Commonwealth of Virginia.
Patient responsibility: The portion of charges deemed to be due from the patient once all insurance payments and adjustments have been applied.
PWH: Prince William Hospital
Self-Pay: Is defined as those patients who do not have insurance.
Self-Pay Plan: Payment arrangement requiring regular periodic payments of a predetermined amount.
Underinsured: Is defined as a patient with insurance that does not cover the cost of services provided. This places a financial burden on the patient (such as large deductible, payment caps, etc.).
Uninsured: Patient with no insurance coverage.
Virginia Indigent Trust: A state-sponsored program that offers charity care equal to 100% of billed charges if the patient's financial condition is determined to fall within the 100% of the federal poverty guidelines.
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