Charity Policy and Discount Schedule
Parmer Medical Center (PMC) is a Non-Profit Community hospital established to serve the health care needs of the citizens of the communities it serves. As a community based non-profit hospital, PMC endeavors to assist those individuals and families who are not reasonably able to pay for all of their medical treatment. Parmer Medical Center’s Charity Care program has been established to provide financial assistance for medical services and treatment provided by PMC. Patients who may qualify for this financial assistance are encouraged to apply for the Charity Care program through the hospital’s business office.
Procedure:
Eligibility Guidelines:
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In order to qualify for the PMC Charity Care Program, the patient must:
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Be a resident living within the Parmer County Hospital District. |
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Meet the criteria relative to the federal poverty guidelines, annual income, and family size, as listed in the “Financial Assistance Schedule.” |
| c. |
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Complete an application for Financial Assistance. |
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Not be eligible (or potentially eligible) for any other programs or benefits and only after all possible sources for payment have been exhausted. If (potentially eligible) for other programs or benefits the applicant must apply for that program or benefit before charity application will be considered. |
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| 2. |
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Applicants must provide written proof of program qualifications, for which any of the documents listed on the “Eligibility Documentation” form may be submitted. |
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| 3. |
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Patients with ongoing chronic illnesses or treatment needs (medically indigent) may be approved for Charity Care based on medical necessity and the obvious financial burden resulting from the continued care required for their chronic illness. |
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A patient may become eligible through physician referrals. Physicians may request that a patient receives services regardless of his/her ability to pay. These requests will be considered on a case by case basis and may require the physician to demonstrate that the service is medically necessary. |
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Based on the completed “Eligibility Determination” form and mandatory documentation, the initial determination is effective for a six (6) month period. |
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| 6. |
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Eligibility status will be reviewed every six (6) months based on the anniversary date the client was deemed eligible. Re-certification is effective for a six (6) month period, and requires the family to complete and submit any documentation necessary to determine continued eligibility. If the family fails to submit the required documentation they will be required to reapply. |
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All applicable hospital discounts will be applied to the account before applying the adjustment for the Hospital portion of the Charity Program. The charges remaining after the Charity Care Program adjustment has been applied will be the patient’s financial responsibility, and must be paid in accordance with Policy 2.003 – Payment Agreement Policy. |
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Notice to the Public:
The Charity Program policy and Financial Assistance Schedule is posted in the Admissions and Emergency Departments of the Hospital. In addition, a summary of the hospitals billing, collections and financial assistance policies and programs will be mailed with all itemized statements.
Financial Assistance Program Discount Schedule
Effective October 1, 2013
| Poverty Level |
100% |
120% |
140% |
160% |
180% |
200% |
| Patient Discount |
100% |
80% |
60% |
40% |
20% |
0% |
| Family Size |
Annual Income |
1 |
11490 |
13788 |
16086 |
18384 |
20682 |
22980 |
2 |
15510 |
18612 |
21714 |
24816 |
27918 |
31020 |
3 |
19530 |
23436 |
27342 |
31248 |
35154 |
39060 |
4 |
23550 |
28260 |
32970 |
37680 |
42390 |
47100 |
5 |
27570 |
33084 |
38598 |
44112 |
49626 |
55140 |
6 |
31590 |
37908 |
44226 |
50544 |
56862 |
63180 |
7 |
35610 |
42732 |
49854 |
56976 |
64098 |
71220 |
8 |
39630 |
47556 |
55482 |
63408 |
71334 |
79260 |
| Each Additional |
4020 |
4824 |
5628 |
6432 |
7236 |
8040 |
| Poverty Level |
100% |
120% |
140% |
160% |
180% |
200% |
| Patient Discount |
100% |
80% |
60% |
40% |
20% |
0% |
| Family Size |
Monthly Income |
1 |
958 |
1150 |
1341 |
1533 |
1724 |
1916 |
2 |
1293 |
1552 |
1810 |
2069 |
2327 |
2586 |
3 |
1628 |
1954 |
2279 |
2605 |
2930 |
3256 |
4 |
1963 |
2356 |
2748 |
3141 |
3533 |
3926 |
5 |
2298 |
2758 |
3217 |
3677 |
4136 |
4596 |
6 |
2633 |
3160 |
3686 |
4213 |
4739 |
5266 |
7 |
2968 |
3562 |
4155 |
4749 |
5342 |
5936 |
8 |
3303 |
3964 |
4624 |
5285 |
5945 |
6606 |
| Each Additional |
335 |
402 |
469 |
536 |
603 |
670 |
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