To guide staff through the complexities of charity care and discount determination, a healthcare provider’s charity care policy should address more than just income and asset criteria.
In addition to financial eligibility criteria, charity care policies should also address:
- Eligibility determinations when there is insufficient information provided by the patient to fully evaluate all the criteria, and the ability to pay cannot be reliably determined.
- The extent of verification necessary for eligibility determinations.
- Any modification of a determination already made if subsequent information indicates the information relied upon was in error.
- The time frame within which patients are eligible for charity care.
- The frequency of evaluation of the adequacy of the charity care allowance.
- Discounts for low-income, uninsured patients who have the ability to pay a small portion of their bill.
- The criteria for a collection to be reasonably assured under GAAP.
Excerpted from “P&P Board Statement 15: Valuation and Financial Statement Presentation of Charity Care and Bad Debts by Institutional Healthcare Providers, HFMA, December 2006.