Financial Assistance Policy

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1.0 Policy

As part of its mission and dedication to the provision of quality medical and other individualized care to those in need, Newton Fire/EMS provides financial assistance to patients who qualify for assistance pursuant to this Financial Assistance Policy. The Financial Assistance Policy is designed to address a patient’s inability to pay for EMS services received from Newton Fire/EMS.

2.0 Purpose

This Policy is intended as a guideline to determine eligibility for the Newton Fire/EMS Financial Assistance Policy.

3.0 Definitions

For the purposes of this policy, the following definitions apply:

Financial Indigence – refers to those suffering severe financial hardship.

Medical Indigence – refers to those who are underinsured or are unable to afford medical care or health insurance coverage.

Presumptive Eligibility – refers to the expectation of qualification for financial assistance when the patient is unable to submit a formal request for consideration of financial assistance and is determined based on individual circumstances (such as when the individual is homeless, has filed bankruptcy or is deceased with no estate).

Medically Necessary – refers to services or supplies that are, as defined by the Centers for Medicare and Medicaid Services, “proper and needed for the diagnosis or treatment of your medical condition, are provided for the diagnosis, direct care, and treatment of your medical condition, meet the standards of good medical practice in the local area, and aren’t mainly for the convenience of you or your doctor.”

Receiving Facility – refers to the hospital, nursing home or other provider location to which the patient is transported by Newton Fire/EMS.

4.0 Eligibility Criteria

Eligibility for financial assistance under the Financial Assistance Policy will be based on a number of factors, including, but not limited to: approval of the Receiving Facility’s Financial Assistance Program, determination of financial or medical indigence, and presumptive eligibility. Newton Fire/EMS will take into consideration a patient’s individual needs and circumstances when evaluating eligibility criteria.

5.0 Services Not Covered Under This Policy

Newton Fire/EMS reserves the right to limit the services covered by this Policy. Services not covered by this Policy include but are not limited to non-medically necessary services. ALS or BLS non-transport services may or may not be medically necessary, based on review of individual circumstances.

6.0 Method For Approval of Financial Assistance

A patient can initiate a request for approval of Financial Assistance in person at Newton Fire/EMS administrative office; over the phone by calling Newton Fire/EMS Billing at 316-284-6199 or Omni EMS Billing at 866-595-4406; or by mailing a written request to Newton Fire/EMS, 200 E. 3rd St, Newton KS 67114. In order to facilitate approval of financial assistance, Newton Fire/EMS will require from the patient a copy of the Receiving Facility’s financial assistance approval letter or payment contract. Approval will be based on review of individual circumstances. It is ultimately the patient’s responsibility to provide the information necessary for approval. There is no guarantee an individual will qualify for financial assistance.

7.0 Measures to Publicize The Financial Assistance Policy

The following measures may be used to publicize the Newton Fire/EMS Financial Assistance Policy to patients and the community:

7.1 Posting the Financial Assistance Policy and a Plain Language Summary of the policy on the Newton Fire/EMS website.

7.2 Providing paper copies of the Financial Assistance Policy and Plain Language Summary upon request at Newton Fire/EMS.

7.3 Distributing information sheets regarding the Financial Assistance Policy to Health Ministries Clinic and New Hope Shelter in Newton.

7.4 Informing patients about the Financial Assistance Policy in person or during billing or customer services phone contacts by Newton Fire/EMS and Omni EMS Billing.

7.5 Including a written notice on billing statements that notifies patients of the availability of financial assistance under the policy and includes the telephone number of the department that can provide information regarding the policy and the approval process, and the website where copies of the Policy and Plain Language Summary can be found.

8.0 Billing and Collections Policy

After the patient’s bill has been reduced based on the Financial Assistance Eligibility Criteria, the patient is responsible for the remainder of the patient’s outstanding account balance. The patient will be invoiced for any outstanding balances in accordance with a separate billing and collections policy.

In the event of nonpayment, Newton Fire/EMS may act as described in the Billing and Collections Policy. A copy of the Billing and Collections Policy may be obtained by calling Newton Fire/EMS at 316-284-6199, mailing a written request to 200 E. 3rd St, Newton KS 67114, or by email.

9.0 Length of Eligibility

Newton Fire/EMS will adopt the length of eligibility determined by approval of the Receiving Facility’s financial assistance program or payment contract.