MOUNT VERNON — Doctor and dentist offices have long required patients to pay insurance co-pays or make full payment when being treated. That billing philosophy has now found its way into hospital emergency departments, including Knox Community Hospital.
“We started planning for it about a year ago,” said Michael Ambrosiani, chief financial officer for KCH. “We just rolled it out recently.”
Patients in the emergency department and the Wellness Center are now being asked to pay their co-pay after treatment has been rendered.
“A person who doesn’t have insurance, we are asking for, if they can, a deposit; it’s $50,” he said. “If they can’t make the deposit, then we will refer them to our financial counselors, if it is convenient, or they can apply for assistance of various types.”
“There are two [assistance programs, the Hospital Care Assurance Program] from the state and our own plan here. We are always developing new plans to help our patients pay bills,” said Stephanie Poland, director of Patient Financial Services.
Over $5.5 million in patient responsibility was forgiven in 2008, Ambrosiani said.
“If they qualify for the HCAP, which is a state-funded program, we are obligated to return any out-of-pocket money paid by any patient,” said Poland.
Patients with insurance may also be eligible for HCAP and KCH funding. To qualify for HCAP, a patient’s gross income must fall within 100 percent of the federal poverty level, which is $22,050 for a family of four. KCH’s assistance program helps those with or without insurance, whose income falls within 200 percent of the federal poverty level, or $44,100.
The $50 deposit, or down payment, was selected, Ambrosiani said, because $50 is a standard co-pay for most insurance plans.
The new procedure will also reduce the cost to the hospital, by not requiring it to continue to send bills or make phone calls to collect on unpaid bills.
“I think it helps the patient not to have to worry about getting a large bill later or getting phone calls if the bill is not paid,” Ambrosiani said. “It’s a lot less expensive for us to collect the bill up front.”
Speaking with patients while they are still on the KCH campus enables employees to gauge whether patients will be in need of financial assistance.
“What it does allow us to do is to have that conversation up front and to identify if they do need that assistance with their bill,” said Poland. “It is easier for us to start to counsel people up front. It takes that burden off of them from worrying about this bill and what options they might have.”
Ambrosiani said no patient is ever turned away from KCH because of lack of ability to pay.
According to a KCH spokesperson, 1,842 private-pay patients were treated in the emergency department between Jan. 1 and June 30.
Licking Memorial Hospital in Newark operates under a similar procedure.
“We do ask for co-pays; however, we take care of all patients, regardless of their ability to pay,” said Tom Argyle, director of public relations for the hospital.
Mansfield’s MedCentral requires payment of co-pays through its Rapid Response or urgent care center, but not through its emergency department.