Methodist Billing and Collection Policy

1 Methodist Billing and Collection Policy The purpose of this Policy is to outline the insurance and self-pay Billing cycle utilized by Methodist Hospital Henderson, Methodist Hospital Union County, and all Methodist Hospital Physician Clinics. Insurance is billed based on information presented by patient at time of registration. Upon completion of the insurance Billing process, any amount deemed by the payer to be patient responsibility or any remaining balance due from a payer for which no facility contract has been established, will be billed to the patient or guarantor. This Policy describes the process and timeframes used in the Billing cycle and the Collection activities (including extraordinary Collection activities). Methodist makes reasonable efforts to promote the availability of Financial Assistance. The financial assistance Policy and application can be found on our website. In addition, financial counselor contact information is given on each first patient Billing statement.

2 Central Business Office employees advise patients who voice financial concerns of the Financial Assistance program availability. Copies of the Charity Application are readily available in the business office and are mailed to patients, upon request. Community United Methodist Hospital Inc is a nonprofit, faith based, healthcare system. Our mission is to provide high-quality, cost-effective healthcare services and to promote wellness in the communities that we serve. Financial Assistance is offered to anyone demonstrating financial need and payment plans are available, upon request. This Policy will be effective upon adoption by the Board of Directors of Community United Methodist Hospital Inc. The Board will review this Policy annually. Definitions Application Period Accounts on or before 240 days from the first patient Billing statement date, will be eligible to apply for financial assistance. Billing Cycle The date on the first patient Billing statement is the date by which all Billing activity is measured.

3 Patients will be sent three statements and a past due notice. The notice will inform patients that Collection activity may begin in 30 days from date of notice. All statements reference financial assistance contact information. Collection Activity On the 121st day from the date of the first patient Billing statement, patient accounts are eligible to be sent to a Collection agency, if approved payment plans are not established and followed and a patient balance due is remaining. The Collection agency will use methods to collect on a debt including Extraordinary Collection activities. Extraordinary Collection Activities (ECA) - Extraordinary Collection Actions (ECA) are defined as those requiring a legal or judicial process, involve selling a debt to another party or reporting adverse information to credit agencies or bureaus. The actions that require legal or judicial process for this purpose include 1) a lien; 2) foreclosure on real property; 3) attachment or seizure of a bank account or other personal property; 4).

4 Commencement of a civil action against an individual; 5) actions that cause an individual's arrest; 6) actions that cause an individual to be subject to body attachment;. and 7) wage garnishment. Financial Assistance Free or discounted services provided to responsible parties deemed eligible through the financial assistance Policy (FAP). Notification Period The first 120 days of the Billing cycle are considered the notification period. Payment Plan Methodist offers 12-month interest free payment plans to persons with or without insurance. Interest free payment plans have a minimum monthly payment of $50. Payment plans greater than 12 months, will be subject to 8 percent interest. Payment plans are established by the Extended Business Office. Point of Service Discount - A 25% discount will be offered to persons who choose to pay at time of service (excludes co-pays). Reasonable Efforts Methodist will make reasonable efforts to determine whether an individual is FAP-eligible.

5 Reasonable efforts include (1) Advise individuals about the FAP while in the hospital or clinic and during the notification period; (2) If an individual submits an incomplete FAP application, Methodist provides the individual with feedback needed in order to complete the FAP application; and (3) generally, in the situation where an individual has submitted a complete FAP application, makes and documents a determination as to whether the individual is FAP-eligible. Policy At time of registration (except in emergency situations) a photo ID and insurance card will be required. For minors, only an insurance card is required. If no insurance card is presented, then the patient will be registered as self-pay. Electronic screening will be attempted, via Relay Health and Greenway Eligibility Verification to attempt to determine eligibility of the insurance card that is presented. All known co-pays will be requested at time of service. Upon complete entry of the charge(s) for service, insurance will be billed.

6 Once payment, adjustment, denial, or patient inquiry is received, the remaining balance will be turned over to patient responsibility and the Billing cycle will begin. For persons without insurance, a 10% discount will be offered for services provided. An application for financial assistance will be offered. Through the financial assistance process, we will first assist the uninsured in obtaining Federal or State aid. If they are unable to qualify for medical insurance benefit, government entitlement programs, and/or any source with which the organization participates, and meets the other qualifications described in the financial assistance Policy , then financial assistance benefits may apply. Anyone without insurance who completes the Financial Assistance process will be granted an additional discount of 25%. Individuals who qualify maybe be eligible for up to a 100% discount. Insurance cards are required at time of registration. Methodist will attempt to bill the insurance that was presented at registration.

7 It is the patient or responsible parties'. responsibility to present accurate and correct information at registration. If an incorrect insurance card is presented at registration, as a courtesy to our patients, Methodist will refile your claim with the correct insurance as long as the claim falls within timely filing limits. If you are past the timely filing deadline for a claim, then the outstanding balance remains patient responsibility. Timely filing limits vary by insurance company and can be as short as 60 days from date of service and can be as long as 365 days from date of service. Billing Cycle Once a balance is deemed a patient's responsibility, the Billing cycle will begin. The first 120 days of Billing cycle is also known as the notification period. The First Statement - The date on the first statement, is the date that all Billing and Collection activity operates off of. This statement will be mailed to the most recent known patient address.

8 This statement will also include a number to call to speak with a financial counselor or set up payment arrangements. The Second Statement - Thirty days after the first statement, a second statement will be mailed. The Third Statement Sixty days after the first statement, a third statement will be sent. The Past Due Notice Ninety days from the first statement, if a financial assistance application, payment in full, or no payment plan has been established, a past due notice will be mailed. This notice will contain the FAP summary and a number to reach a financial counselor to assist with payment plan/or and financial assistance questions. A. notice on the front of the statement informs the responsible party that the financial assistance application is located on the back of the statement. This serves as notice that 30 days from the date listed on the statement the account will be turned over to a Collection agency and the initiation of extraordinary Collection activities may begin.

9 The notice defines Extraordinary Collection Actions (ECA) as those actions requiring a legal or judicial process, involve selling a debt to another party or reporting adverse information to credit agencies or bureaus. The actions that require legal or judicial process for this purpose include 1) a lien; 2) foreclosure on real property; 3) attachment or seizure of a bank account or other personal property; 4) commencement of a civil action against an individual; 5) actions that cause an individual's arrest; 6) actions that cause an individual to be subject to body attachment; and 7) wage garnishment. A copy of the plain language summary will be included in this notice. Collection Agency Once a balance is deemed a patient's responsibility, the self-pay Billing cycle begins. Three separate statements and 1 past due notice are sent, each statement/notice will include a number to reach a financial counselor to assist with payment plan and financial assistance questions.

10 A notice on the front of the statement/notice informs the responsible party that the financial assistance application is located on the back of the statement/notice. On the 121st day from the first statement if an appropriate response has not been received from the patient the account is then eligible to be sent to a Collection agency. Prior to sending an account to the Collection agency a review of each account will take place by a Methodist Financial Counselor. This review will include: Review of account Billing activity Verification of completion of Billing cycle (3 statements and past due notice), Presumptive eligibility Oral notification of the FAP and payment plans to those accounts subject to ECA's. Once this review is complete the account will be eligible to be turned over to a Collection agency. Once an account it turned over to a collections agency, the account is eligible for extraordinary Collection activities. Extraordinary Collection Actions (ECA) are defined as those requiring a legal or judicial process, involve selling a debt to another party or reporting adverse information to credit agencies or bureaus.