Financial Assistance Policy and Application
- Hospital Bill Reduction Application(English)
- Hospital Bill Reduction Application(Spanish)
- Financial Assistance Policy
Financial Assistance Policy – Plain Language Summary
Bay Area Hospital’s Financial Assistance Policy (FAP) exists to provide patients with a variety of options to choose from in order to resolve their financial liability for services rendered.
Financial assistance options are as follows:
· Hospital Bill Reduction (HBR) using Amount Generally Billed (AGB) Discount (http://www.bayareahospital.org/Financial-Services).
· Federal Poverty Level (FPL) Discount
· Un-insured Discount (for patients not eligible for AGB Discount)
· Prompt Pay Discount
Eligibility for HBR Discount: Eligibility for HBR discount will be considered for those individuals who are uninsured, underinsured, ineligible for any government health care benefit program, and who are unable to pay for their care, based upon a determination of financial need in accordance with this Policy. The granting of HBR discounts shall be based on an individualized determination of financial need, and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation. An HBR discount approval covers current accounts for services covered under this policy with a balance due. The HBR discount approval also applies to services covered under this policy for twelve months from the date of approval. Bay Area Hospital reserves the right to request a new HBR application at any time. Eligibility for the HBR discount will be determined by evaluating family income, family size and the current calendar year federal poverty level. Patients in families whose applicable family income is below the federal poverty level for the size of the family, will be considered eligible for the HBR discount.
Services Eligible for HBR:
· Emergency medical services provided in an Emergency Department setting;
· Services for a condition which, if not promptly treated, would lead to an adverse change in the health status of an individual;
· Non-elective services provided in response to life-threatening circumstances in a non-emergency room setting; and
· Medically necessary services, evaluated on a case-by-case basis at Bay Area Hospital’s discretion.
How to Apply for the HBR: Applying for HBR may be done prior to services or within two hundred forty (240) days from the first patient balance statement mail date. HBR applications may be obtained in the Hospital from the Patient Access and Patient Accounts departments; or printed from www.bayareahospital.org; and are included with certain patient statements. You may receive additional information on the application in the Patient Accounts department in the Hospital.
Applicants who qualify for the HBR discount will not be required to pay more than the Amounts Generally Billed for the eligible services (emergency or other medically necessary care) received. Applicants approved for HBR discount are also eligible for an additional discount depending on family income as a percentage of current federal poverty levels.
A free copy of the full Financial Assistance Policy is available to the public at www.bayareahospital.org/Financial-Services or upon request, in person or in writing, by contacting the Patient Accounts department at (541) 269-8131. Copies are available in English, and Spanish.