ASHEVILLE — Pressure from patient advocates on HCA Healthcare paid off Nov. 17 when the company made a sample of its charitable care financial assistance request public online on the Mission Health website.
Mission is perhaps the first of all HCA hospital systems – there are more than 180 in its network in the US and UK – to make this document immediately available online for patients.
The Application is a two-page form that eligible patients can use to request waiver of medical bills under HCA’s Charitable Care Policy.
After:Despite requests from the patient advocate, the HCA mission has yet to make the request for charitable care public.
The move follows a partnership that began in July with leaders of social media group WNC Mountain Diseases and medical debt solutions organization Dollar For.
Mountain Diseases, a 13,500-member Facebook group founded and hosted by western North Carolina resident Will Overfelt, asked Mission Health and its owner HCA to make the app public so local residents who wanted to apply for charity care can do so easily.
Overfelt wanted to partner with Portland-based Dollar For, founded and run by Jared Walker, to use the organization’s free services helping patients “crush medical debt.”
When Overfelt, in a Sept. 13 letter, asked Steve Gross to apply with Parallon — which provides billing services for HCA — Gross responded but did not send the document.
Shortly thereafter, North Carolina State Treasurer Dale Folwell wrote his own letter to Gross, reiterating Mountain Maladies and Dollar For’s request.
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The Citizen Times also requested the application form and reported on the situation in an October 31 article. HCA and Mission Health spokeswoman Nancy Lindell responded to questions from The Citizen Times but did not send a copy of the request.
“While we consider the merits of providing the online application, it is important to note that our financial assistance process begins the moment care begins and we encourage conversations with our financial advisors so that we can help each person find the most useful help for their unique situation,” Lindell said Oct. 27.
But on Nov. 17, Lindell emailed Overfelt with a link to the app, which is now live on the Mission Health website.
“I understand you contacted Steve Gross recently and wanted to follow up with my contact information,” Lindell said. “Do not hesitate to contact me for any reason, I am happy to do my best to assist you. In regards to your request to Steve, a sample of our application has been posted on our website.”
The document is posted at www.missionhealth.org/financial-services/financial-support under a link titled “Click here to see a sample application for financial assistance”.
Before this document went online, patients who wanted to inquire about their eligibility for charity care had to request a kind of screening interview with a “benefits advisor”.
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Having the application details on hand can simplify this process.
“It’s a small victory but a victory nonetheless,” Overflet said of the app release. “Collaboration and compromise are possible even when different parties have very different perspectives. We won’t know if this will have any tangible benefit for the citizens of WNC until we have the chance to help those seeking charity care submit an application on the form. But it’s a step toward transparency and streamlining the charitable care process for hardworking WNC workers who are saddled with huge medical bills.
Overfelt encouraged WNC residents who need help with the charitable care application to contact HCA or Dollar For help directly by visiting DollarFor.Org/Asheville.
Dollar For can also help patients fill out charitable care applications at other local hospitals such as AdventHealth or Pardee, he noted.
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Folwell praised advocates like Overfelt and noted the work of Take Medicine Back, which hosted a forum in July with the treasurer and other patient advocates, including Walker.
“What I would say in the spirit of Tom Petty is that we are going to the gates of hell before we give up transparency, quality and access to health care in the west of North Carolina,” Folwell told the Citizen Times on Nov. 18. “We have tried to get the law changed to bring the right degree of transparency on these matters.”
As previously reported by the Citizen Times, Folwell has championed better charitable care practices in the state, simultaneously condemning the “failures” of the system. His office reported in January that some of North Carolina’s hospitals “billed $149.2 million to poor patients who should have received free or reduced-cost charity care under the hospitals’ own policies over the course of the year. fiscal year 2019”.
More recently, his office released another report that found “huge disparities between Medicare losses claimed by hospital executives and the numbers that hospitals reported to the federal government.”
On November 18, he said that “the credit for this small step goes to all of us who sing from the same hymnal”.
HCA still thinks a phone call is best
The publication of this application on the Mission Health website may be the first time the document has been made immediately available to the public by an HCA hospital system.
As of November 18, for example, the application for financial assistance has not been posted on HCA’s TriStar Health website. TriStar is a network of 17 hospitals in Tennessee and Kentucky. HCA’s corporate headquarters are located in Nashville, Tennessee.
The Citizen Times sent a series of questions to Lindell on Nov. 17 regarding greater publicity of the application for financial aid.
- Is the Charitable Care Application posted online for the Mission Health Network the only application form posted by an HCA hospital? In other words, did other hospitals or HCA hospital networks submit the application? Is the app available on the main HCA website, and if so, how long has it been published there? If not, will HCA post it there and other hospitals?
- What prompted Mission Health to publish the app on their website?
- Has Mission Health recently seen a noticeable increase in requests for charity care?
Lindell responded, but did not directly address some of these issues.
“We are always looking for ways to improve and a representative from our billing department received a request to have the charity care application posted online,” she said, noting that the company continues to believe in efficiency of a phone call rather than simply returning a request. in.
“In our experience assisting patients over the years, a conversation with a benefits advisor provides a more complete picture of a patient’s situation, allowing us to identify solutions that help determine eligibility for coverage that can often extend beyond their current salary. For example, in North Carolina over the past year, our advisors have helped more than 13,900 patient accounts enroll in longer-term coverage such as Medicaid.
She added that the company is “proud of the more than $277 million” it provided in financial relief last year.
“We have not seen an increase in the number of applications since the sample was recently released.”
Charitable care, as defined by the North Carolina Healthcare Association, is “services provided free of charge or with a substantial discount.”
Each hospital has different policies, and while nonprofits like Novant and AdventHealth are required to provide charitable care in order to qualify for tax-exempt status with the federal government, for-profit hospitals like HCA do not. are not.
Walker said Dollar For was already processing applications for financial assistance from Mission Health after the application was released, but he feared his team and applicants would face more hurdles.
“We have the application, we asked them to post it on their site,” Walker said Nov. 18. “The question now is, will they accept applications here? If we start sending applications, will they accept them and process them? Or will they say again, ‘You need to speak to a financial adviser before we even ‘examine?
There is also the question of how to submit the application. Walker said in a recent interview that many hospitals require applicants to fax or mail documentation, an outdated and cumbersome process.
Either way, he said the information was helpful to some extent and encouraged HCA to post the application on the rest of his hospital websites.
“If you cared about the financial well-being of your patients, you would give them access to the lowest resource you have to help them escape financial ruin from medical debt,” Walker said.
Need help with medical debt?
More information on whether Mission Health patients are eligible for charity care or other financial assistance is available at missionhealth.org. Dollar For also helps patients determine if they are eligible and how to apply. Mission patients can begin this process at dollarfor.org/asheville.
Andrew Jones is an investigative reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach him at @arjonesreports on Facebook and Twitter, 828-226-6203 or firstname.lastname@example.org. Help support this type of journalism by subscribing to the Citizen Times.
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