Financial Assistance Program

Purpose

Warren General Hospital maintains a program to provide free or discounted medical services to qualifying individuals. “Financial Assistance” means free and discounted care.


This summary outlines the circumstances under which Financial Assistance may be provided to qualifying low-income patients for all emergency and medically necessary healthcare services.  A person’s examining physician determines emergency and medically necessary services.


Eligibility

In order to make the best use of available resources, Warren General Hospital requires that patients/families attempt to obtain any assistance potentially available from government and non-government assistance programs, including:


• Medicaid
• The Children’s Health Insurance Program (CHIP), and
• Publically supported Insurance Exchange Products.

Financial assistance is secondary to all other financial resources available to the patient.

Discounted care is available to individuals whose household income is less than 300% of the Federal Government Poverty Income Guidelines. The level of discount will be based upon the individual’s income, financial resources, and household size. Free care is available to individuals whose household income is less than 200% of the Federal Government Poverty Income Guidelines.


Method for Applying for Financial Assistance

Individuals may request a Financial Assistance application within 120 days of the date of the first bill. For more information about Financial Assistance, patients may contact the Hospital Financial Counselor at (814)-723-4972, ext. 1325 or at 2 Crescent Park West, Warren, PA 16365, first-floor office. 


Individuals interested in Financial Assistance must complete the Hospital’s Financial Assistance Application and provide all requested documentation of assets.  For a copy of the Hospital’s Financial Assistance Policy and/or a copy of the Financial Assistance Application form, click on the links below or contact the Financial Counselor at (814)-723-4972, ext. 1325, or at crrebecca@wgh.org. The Financial Counselor will send a copy of the Financial Assistance Policy and/or a copy of the Financial Assistance Application form by e-mail or regular mail upon request.
The direct website address of the Financial Assistance application is:  https://virteomdevcdn.blob.core.windows.net/site-wgh-org/content/FAP_application_for_wgh.org%20web%20site%209-14-15%5B2%5D.pdf


An individual may obtain a copy of the Financial Assistance Policy and/or a copy of the Financial Assistance Application form on-site at the Hospital, 2 Crescent Park West, Warren, PA 16365, from the Financial Counselor on the first floor or from the Patient Accounts Manager on the second floor.


Individuals must also make timely application for the Medical Assistance Program as a condition of obtaining free or discounted care. The Financial Counselor or the Patients Accounts Manager will review the application and make a determination as to eligibility and the amount of free or discounted care. The individual will be notified of the determination of eligibility within 30 days of submitting a complete application. 

Basis for Calculating Charges

Warren General Hospital determines the basis for calculating amounts charged to patients by using the Look Back Method. Once per year, The Hospital calculates the Amount Generally Billed (AGB) percentage by Medicare fee-for-service. The AGB percentage is applied to gross charges for services provided to the patient. The patient will be required to pay the lesser of the AGB percentage of gross charges or the financial aid percentage of gross charges as determined by the financial counselor.


Delinquent Accounts

WGH reserves the discretion to take any lawful measures to collect the debt, including the use of third-party collections agencies, reporting debts to credit agencies, and obtaining a lien or judgment on the individual’s property if an individual does not pay (or set up a payment plan for) an outstanding balance.


Failure to Pay

If a patient fails to pay the self- pay portion of discounted care invoices the patient will be disqualified from receiving future financial assistance until the outstanding delinquency is paid in full.


Records

WGH will maintain documentation of each individual’s application for the financial assistance program and the amount of financial assistance the applicant received. The Hospital will review an individual’s prior Financial Assistance eligibility but will not use prior eligibility to presumptively determine continued and ongoing eligibility.

CLICK ON THIS LINK TO VIEW AND PRINT THE FINANCIAL ASSISTANCE APPLICATION, Policy and/or Appendix.

  Financial Assistance Application

 Financial Assistance Policy 101.02

 Financial Assistance Policy Appendix