Highland-Clarksburg Hospital Financial Policy

Financial Counseling

Revised: 6-12-2017

It is the policy of Highland-Clarksburg Hospital to make financial counseling services available to all patients, including information about Charity Care and Sliding Scale discount policies that are available to qualified individuals. Financial counseling is not considered a condition of admission. Patients who present themselves for emergency examination or treatment will be treated regardless of their ability to pay for services. The patient will be given the opportunity to request a patient advocate, designee or family member to assist in the financial counseling discussions. Financial counseling may occur at any time from admission to discharge as long as the patient’s care is not interfered with and the patient consents to the discussions.

Uninsured Patients

Patients with no third party reimbursement source will be informed of payment responsibility prior to admission. Patients will be offered the services of Hospital’s designated Financial Counselor to apply for other forms of assistance such as WV Medicaid or obtaining coverage through the Healthcare Market Place.

Charity Care and Sliding Scale Discounts

In concert with the Hospital’s Mission to “identify and respond to the healthcare needs of the community and promote physical, social, emotional and intellectual well-being,” Highland-Clarksburg Hospital’s charity care policy was developed to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care.

It is the policy of Highland-Clarksburg Hospital, Inc. to provide Healthcare Services at the usual and customary rate prevailing in this area. Further, we will provide essential medical services to all patients regardless of the patient’s ability to pay. Discounts are offered based upon household income and size. A sliding fee schedule is used to calculate the basic discount and is updated each year using the federal poverty guidelines.

Highland-Clarksburg Hospital will make available charity care services for parties who are not covered under any other benefit plans and meet certain income eligibility requirements. The current Federal Poverty Guidelines are used to determine patient eligibility for uncompensated services. Persons whose individual or family income for twelve (12) months preceding determination of eligibility is equal to or less than the
Federal Poverty Level may receive services at no charge. Charity care is not available to assist with deductibles, co-pays, and/or co-insurance.
The current Federal Poverty Guideline is as follows:

Persons in Family Poverty Guideline
1 $12,060
2 $16,240
3 $20,420
4 $24,600
5 $28,780
6 $32,960
7 $37,140
8 $41,320

For families/households with more than 8 persons, add $4,180 for each additional person.

Discounted/Sliding Fee Pay Classes are as follows:
Annual Income Thresholds by Sliding Fee Discount Pay Class and Percent of Poverty

PERSONS IN FAMILY
(family unit size)
100% pay 125% pay 150% pay 175% pay 200% pay >200% pay
Poverty No Pay 20% Pay 40% Pay 60% Pay 80% Pay 100% Pay
1 $12,060 $15,075 $18,090 $21,105 $24,120 $24,121
2 $16,240 $20,300 $24,360 $28,420 $32,480 $32,481
3 $20,420 $25,525 $30,630 $35,735 $40,840 $40,841
4 $24,600 $30,750 $36,900 $43,050 $49,200 $49,201
5 $28,780 $35,975 $43,170 $50,365 $57,560 $57,561
6 $32,960 $41,200 $49,440 $57,680 $65,920 $65,921
7 $37,140 $46,425 $55,710 $64,995 $74,280 $74,281
8 $41,320 $51,650 $61,980 $72,310 $82,640 $82,641
For each additional
person, add
$4,180 $5,225 $6,270 $7,315 $8,360 $8,361

Patients who fall below 100% of the federal poverty level may be referred to the Highland companies’ charity assistance program.

Financial assistance/charity care is predicated upon the completion of an Application for Sliding Scale Discount for the individual or household. Completion of the Application for Sliding Scale Discount will include but may not be limited to:

  • Demographic Information
  • Sources of income
  • Monthly earnings from employer
  • Total household income
  • Proof of income (current tax returns and/or current pay stubs)

An associate from our Business Office is available to assist patients in this process and will analyze the Application for Sliding Scale Discount according to our guidelines in our Financial Assistance/Charity Care Policy. If there are items missing, you will receive a letter indicating what items we may require to complete processing.

Financial assistance eligible patient’s discounts will be applied to Amounts Generally Billed (AGB). Amounts Generally Billed is calculated by a look back during the prior 12 month period of all medically necessary care allowed by all health insurers including Medicaid. Once approved, the discount will be honored until a change in financial status occurs. Financial information will be verified at each office visit. Patients who are discharged must reapply for assistance.

Delinquent Account Collection

Former patients with delinquent Private Pay accounts will be notified and given the option of paying the account in full or participating in a predefined monthly payment plan. Former patients will be notified of their financial obligation for services rendered by receiving monthly statements with balance due. Former patients, who did not wish to apply during their hospitalization, will be given another opportunity to apply for Charity Care or Sliding Fee Scale financial assistance programs during the collection process.

Other Information

A paper copy of this Financial Assistance Policy can be obtained upon request and free of charge by calling 304-969-3100 or 855-432-4042.

Events
  1. Soles for September Shoe Drive

    September 1 - September 30
  2. CRAFT/Beyond Addiction: Help for Parents & Partners

    September 20 @ 5:00 pm - 6:00 pm
  3. CRAFT/Beyond Addiction: Help for Parents & Partners

    September 27 @ 5:00 pm - 6:00 pm
  4. CRAFT/Beyond Addiction: Help for Parents & Partners

    October 4 @ 5:00 pm - 6:00 pm
  5. Fall Conference

    October 5 @ 8:00 am - October 6 @ 4:30 pm
The Joint Commission National Quality Approval for Highland-Clarksburg Hospital — Behavioral and Mental Health Hospital

Highland-Clarksburg Hospital awarded Hospital
Accreditation from the Joint Commission

Highland-Clarksburg Hospital announced it has earned The Joint Commission's Gold Seal of Approval for Hospital Accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal of Approval is a symbol of quality that reflects an organization's commitment to providing safe and effective patient care. The Joint Commission generally reviews a Hospital's accreditation on a tri-annual basis. Highland-Clarksburg's original accreditation was October 2013.

Highland-Clarksburg Hospital
3 Hospital Plaza, Clarksburg WV 26301 / Phone: 304-969-3100
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Highland-Clarksburg Hospital is an equal opportunity provider and employer.