Billing, Collections, and Financial Assistance

Effective May 20, 2024, Munising Memorial Hospital implemented a new credit and collections policy.

Policy Key Points

• Payment Arrangements
• Financial Assistance

If you need to apply for financial assistance please download the 
Financial Assistance Application. Please sign and mail this application to the hospital for our billing specialists to review. You can consult our Sliding Scale for Financial Assistance to see if you may qualify.

Financial Assistance Policy

The full policy can be read below. A link to the PDF version, as well as PDF copies of the Plain Language Summary of the Financial Assistance Policy, Financial Assistance Policy Application Form, and Sliding Fee Scale for Financial Assistance, can also be found below.

Click here for the full FINANCIAL ASSISTANCE POLICY.

Click here for the FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY.

Click here for the SLIDING FEE SCALE FOR FINANCIAL ASSISTANCE.

Click here for the FINANCIAL ASSISTANCE POLICY APPLICATION FORM.

POLICY:

Munising Memorial Hospital is committed to the provision of health care services to all persons in need of emergency and/or medically necessary care regardless of ability to pay.  The hospital is committed to providing free or reduced cost care to persons who have health care needs and are uninsured, under insured, ineligible for a government program, or are otherwise unable to pay for medically necessary care based on their individual financial situation.

Munising Memorial Hospital will not refuse, delay or discourage emergency and/or medically necessary services based upon a patient’s ability to pay for the cost of such services in accordance with the Emergency Treatment and Active Labor Act (EMTALA).

PROCEDURES:

Services Eligible Under This Policy:

• Except as otherwise indicated below, all medically necessary services provided by Munising Memorial Hospital, Munising Memorial Hospital Emergency Department Providers and BayCare Rural Health Clinic Providers are potentially eligible for free or reduced cost care.
• Eligibility determination must be made in accordance with financial assistance program application, required additional documentation, and corresponding procedures.
• The following services are not eligible for free or reduced care because they are billed by organizations other than Munising Memorial Hospital – General Surgery professional fees, Anesthesiologist / CRNA professional fees, Dermatologist professional fees, Radiologist professional fees, Pathologist professional fees.

Communication to the Public:  Information about Munising Memorial Hospital’s financial assistance policy shall be made publicly available as follows:

• The Financial Assistance Policy, the Financial Assistance Policy Application Form, the Sliding Fee Scale for Financial Assistance, and a Plain Language Summary of the Financial Assistance Policy will be available on the hospital website.
• A paper copy of the Financial Assistance Policy documents will be available upon request and without charge, both by mail and in public locations throughout the hospital and rural health clinic.
• MMH will distribute a copy of the Plain Language Summary with the billing statements that notifies and informs recipients about the availability of financial assistance under the hospital’s policy. The Plain Language Summary Notice will include the telephone number of the Patient Financial Counselor as well as a website address where copies of the Financial Assistance Policy Documents may be obtained.
• A conspicuous notice advising patients that MMH provides financial assistance and reduced fee or free care will be posted in key public areas of MMH, including Admissions, the Emergency Department, the Rural Health Clinic, and the Business Office.
• MMH will train front-line staff to answer financial assistance questions effectively or to direct any inquiries to the designated Patient Financial Counselor.
• Financial Assistance Policy documents will be made available in any language spoken by more than 5% of the population in the hospital’s service area, and interpreted for other non-English speaking or limited English proficiency patients.
• The Financial Assistance Policy will be publicized in the communities served by the hospital and rural health clinic.

Determination of Financial Need:

Financial need will be determined in accordance with procedures that involve an individual assessment of financial need, and will include an application process in which the patient or the patient’s guarantor is required to cooperate and supply personal, financial and other information and documentation required for determining financial need.  The request for financial assistance application and corresponding documentation must be completed and submitted within timelines established by Munising Memorial Hospital.

APPLICATION AND ELIGIBILITY CRITERIA:

• Eligibility Criteria for Financial Assistance for free or discounted care will be determined, based upon completion of a FINANCIAL ASSISTANCE POLICY.
• Patients or their guarantors wishing to apply for financial assistance are encouraged to submit a Financial Assistance Application within ninety (90) days of their date of service or discharge. Patients or guarantors may submit an application up to two hundred forty (240) days from the date of the patient’s first post-discharge billing statement.  However, accounts may be subject to ECA (extraordinary collection actions) collection efforts, including notification of credit agencies, as soon as one hundred and twenty (120) days after patients or their guarantor(s) have been provided the first post-discharge statement.
• Applications for Financial Assistance must include proof of income documentation.
• “Income” is defined as gross income, or all income before taxes. This would include any interest, dividends, wages, compensation for other services, tips, pensions, fees for earned services, price of goods sold, income from rental property, gains on sale of other property, alimony, or royalties, etc.
• Patients must include the following documentation with their Financial Assistance Application:
• Copy of most recent pay stub showing year to date income.
• Copy of most recent signed federal tax return (including all pages and schedules).
• Copies of documentation, income-generating statements or award letters to verify additional household income.
• In the event that a patient has zero income, evidence that the patient has applied for Medicaid, and a signed statement from the patient indicating how they are surviving with zero income.
• “Household” includes all individuals listed on a patient or guarantor’s federal income tax filing. Guarantor’s of a minor dependent who do not claim the dependent on their federal taxes may submit a court decree as proof of the dependent’s household status.  In the event the patient’s (except for minor patients) income does not warrant a filing of a federal tax statement, the patient/guarantor may submit a signed statement that indicates how they are surviving with no income.

SLIDING FEE SCALE:

• Services will be made available to qualified patients on a SLIDING FEE SCALE, in accordance with financial need, as determined in reference to Federal Poverty Guidelines in effect at the time of determination.

Munising Memorial Hospital

Credit and Collections Policy:

POLICY:

The credit and collections policy of Munising Memorial Hospital is designed to preserve a sound financial basis for operations of the institutions in order that vital essential services may be obtained.  The policy establishes a responsibility for the prompt collection of patient charges.  This policy establishes a responsibility for the prompt collection of patient charges.  This policy applies to all individuals who receive services from Munising Memorial Hospital, and from that, establish a financial obligation.

Munising Memorial Hospital will not refuse, delay or discourage emergency and/or medically necessary services based upon a patient’s ability to pay for the cost of such services in accordance with the Emergency Treatment and Active Labor Act (EMTALA).

Patients are responsible for providing accurate insurance information at the time of service.

1. Self-pay and any after insurance amounts are due at the time of service.
2. In the clinic setting, the time of service collection will be collected before the visit.
3. Payment may be made with cash or credit card. MMH accepts Visa and MasterCard.
4. If insurance benefits are not received within sixty (60) days from the billing date, the patient must pay the account or make credit arrangements with MMH.
5. Small Balances will be adjusted in accordance with the MMH Small Balance Adjustment policy.
6. Financial Assistance Adjustments will be applied in accordance with the MMH’s Financial Assistance Policy.
7. Employee Adjustments will be applied in accordance with the Employee Discount policy.
8. An attempt will be made to collect the entire amount due as payment in full.
9. Monthly installments are available if MMH’s minimum payment is met. The following minimum payments apply to the combined hospital/clinic total balance per guarantor:

Balance:                    Target Minimum Monthly Payment:

$0 – $500                   $50

$501 – $1,000           $75

$1,000 – $2,000       $100

$2,001+                     at least 10% of total with balance to be paid off in 18 months or less.

10. An initial statement will be sent to the responsible party for the patient’s financial obligations. This will be done in accordance with the financial assistance policy.
11. MMH will issue subsequent billings at least every 30 days, and for a minimum of 120 days after the initial bill, before referring an account to an external collection agency. The patient will receive at least 3 billing statements and a “final notice” indicating that the account will be referred to an external agency when an acceptable payment has not been received or when an appropriate payment plan has not been established.
12. The statement or billing notices will be accompanied by telephone calls, collections letters, personal contact notices, and any other notification method that constitutes a genuine and responsible effort to contact the party responsible for the obligation.
13. Alternative payment plans may be approved through the executive administrative team on a case by case basis.

All charges are due at the time of service. To aid in your payment, a monthly installment plan is available. That plan must be established sometime within the billing schedule. The timeline for billing depends upon whether you have insurance coverage or will be paying for services yourself. MMH will issue bills/statements on the following schedule:

For patients with insurance

15 days                         Bill sent to insurance company/(s)

30-60 days                   1st statement sent to patient

60-90 days                   2nd statement sent to patient

90-120 days                 3rd statement sent to patient

*After 30 more days account turned over to an outside collection agency

For patients without insurance

15 days                           1st statement sent to patient

45 days                          2nd statement sent to patient

75 days                          3rd statement sent to patient

105 days                        4th statement sent to patient

*After 30 more days account is turned over to an outside collection agency

In order to qualify for Financial Assistance, patients must first exhaust other resources, including:

• group or individual medical plans
• worker’s compensation
• Medicare, Medicaid, or other medical assistance
• other state/federal/military programs
• third-party liability or any situation where another person/entity has a legal responsibility to pay for your medical services

Services that qualify for financial assistance include:

• emergency medical services (provided in the ER)
• non-elective services provided in response to life-threatening circumstances
• medically-necessary services, evaluated on a case-by-case basis at MMH’s discretion

If the items above accurately reflect your situation, ask a billing representative about financial assistance. You will be required to provide proper documentation to demonstrate need for assistance.

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