Patient Financial Information
Under the Affordable Care Act, a hospital that is partially or wholly owned by a tax-exempt organization generally must follow certain requirements. These requirements, which are defined in Section 501(r) of the Internal Revenue Code, provide that the hospital must:
- Conduct a community health needs assessment (CHNA) every three years
- Adopt an implementation strategy to meet the community health needs identified through the CHNA
- Establish a written financial assistance policy (FAP) that includes eligibility criteria and the method for applying for financial assistance, among other provisions
- Establish a written emergency medical care policy that requires the provision of care to individuals for emergency medical conditions regardless of their eligibility for financial assistance
- Limit amounts charged for emergency or other medically necessary care provided to individuals eligible for financial assistance to not more than amounts generally billed (AGB) to insured patients
- Refrain from engaging in extraordinary collection actions before making "reasonable efforts" to determine whether individuals are eligible for financial assistance
We provide on this page an overview of our hospital's efforts to follow the requirements of Section 501(r).
What is the Financial Assistance Policy (FAP)
Our hospital maintains a written Financial Assistance Policy, which applies to all emergency and medically necessary care provided by our hospital to patients who are uninsured and who otherwise satisfy the eligibility criteria described in the FAP.
View or Download the Financial Assistance Policy
View or Download the Financial Assistance Policy (Spanish Translation)
Additional Financial Assistance Policy Appendixes
Included separately from the Financial Assistant Policy are a few additional documents, listed and downloadable below. Click to download.
Billing & Collections Policy
Financial Assistance Application
- Financial Assistance Application (Spanish Translation)
Plain Language Summary of the Financial Assistance Policy
- Plain Language Summary (Spanish Translation)
Emergency Care Policy
Our FAP and our Emergency Medical Treatment and Labor Act (EMTALA) Policy state that we:
- Provide care for medical conditions without discrimination and regardless of FAP eligibility
- Disallow actions that discourage individuals from seeking medical care
If you are unsure about any of the above, or have questions, feel free to contact the hospital using our Contact Us page.