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Current Status: Active PolicyStat ID - Piedmont

COPYC urrent status : Active PolicyStat ID: 8558187 Origination Date: 4/1/1992 Version Effective Date: 9/29/2020 Last Approved: 9/29/2020 Last Revised: 9/29/2020 Next Review: 9/29/2023 Owner: Leah Mctague: VP RevenueCycle Transformation Document Area: Patient Financial Services Document Groups: Applicability: Piedmont Healthcare System Financial Assistance Policy 1. Purpose Includes eligibility criteria for financial assistance. Describes the method by which patients may apply for financial assistance. Describes the process used to determine financial assistance, the appeal process and presumptive eligibility. Describes how PHC will widely publicize the policy within the communities served by each PHC facility.

4. Policy . COPY. 4.1. Eligibility Criteria for Financial Assistance . Persons in family/household Poverty guidelines 1 $12,880 2 $17.420 3 $21,960

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