HSHS Medical Group Inc

HSHS MEDICAL GROUP IS THE PHYSICIAN ORGANIZATION OF HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), A HEALTH CARE MINISTRY OF THE CATHOLIC CHURCH. AS A MISSION-BASED ORGANIZATION, IT IS OUR DESIRE TO CONNECT WITH ALL WHO SEEK CARE, HEALING, AND HOPE. PRIMARILY THE MISSION IS FILLED THROUGH PATIENT ACCESS OF PRIMARY CARE PROVIDERS, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, AND PEDIATRICS. TO ENSURE ACCESS TO HEALTH CARE FOR ALL, A CHARITY CARE POLICY HAS BEEN IMPLEMENTED FOR ALL PRACTICES OF THE HSHS MEDICAL GROUP. THE CHARITY CARE POLICY HELPS ENSURE THAT ALL WHO COME TO US WILL RECEIVE QUALITY CARE, AND ARE TREATED WITH RESPECT AND COMPASSION. THE HSHS MEDICAL GROUP CHARITY CARE POLICY PROVIDES PATIENTS WITH AN OPPORTUNITY TO QUALIFY FOR FINANCIAL ASSISTANCE WHEN RECEIVING NON-ELECTIVE SERVICES. THE LEVEL OF CHARITY CARE ASSISTANCE FOR WHICH ANY PERSON IS ELIGIBLE IS BASED, IN PART, ON THEIR INCOME COMPARED TO THE CURRENT YEAR FEDERAL POVERTY GUIDELINES. TO QUALIFY FOR CHARITY CARE, A PERSON COMPLETES A TWO-PART INCOME TEST. PART ONE DETERMINES THAT NO OTHER GOVERNMENTAL OR PRIVATE INSURANCE IS AVAILABLE TO THE PERSON. PART TWO FOLLOWS A PROCESS TO DETERMINE THE CHARITY AMOUNT IN RELATIONSHIP TO THE PERSON'S/FAMILY'S INCOME. THE HSHS MEDICAL GROUP CHARITY CARE PROGRAM IS BASED ON THE CURRENT YEAR FEDERAL POVERTY GUIDELINES ("FPG") ISSUED BY THE DEPARTMENT OF HEALTH & HUMAN SERVICES ANNUALLY AND PUBLISHED IN THE FEDERAL REGISTER. AN FPG AND CHARITY ALLOWANCE TABLE IS UPDATED ANNUALLY BY THE HSHS MEDICAL GROUP AND IS USED TO DETERMINE WHETHER THE PERSON QUALIFIES FOR CHARITY CARE AND, IF SO, AT WHAT LEVEL. THE AMOUNT IS DETERMINED BY MULTIPLYING THE ALLOWANCE LEVEL SPECIFIED IN THE TABLE BY TOTAL CHARGES CALCULATED USING THE RATE OF 150% OF THE MEDICARE ALLOWABLE CHARGE FOR EACH ITEM OR SERVICE RENDERED DURING THE VISIT BASED ON THE APPLICABLE MEDICARE LOCALITY.