Question: Question on charity – Medical Bill Survival Guide
The Medical Bill Survival Guide complete book
Available Now: Medical Bill Survival Guide by Nicholas Newsad in print and e-book format at Amazon.com

Second place in the Reader Views Literary Awards, "Health" and "How To" categories

It does not matter how bad your financial situation seems to be, The Medical Bill Survival Guide will provide you with the knowledge to help yourself or your loved one. Medical bill anxiety is caused by miscommunications and misunderstandings. This book teaches easy, effective strategies for working with insurance companies, hospitals, doctors, and other healthcare providers.

Readers will learn and discover:
  • How process problems cause insurance claims to be rejected and denied
  • How to access public insurance programs for the uninsured and unemployed
  • How to access provider-based financial assistance and charity care
  • How to demonstrate financial hardship and
  • How to talk productively to billers and collectors.
The information in this book will benefit:
  • Insured patients who are experiencing difficulty paying the deductibles, co-pays, and coinsurance.
  • Uninsured patients who are unemployed or cannot afford health insurance.
  • Patients and the families of patients who have survived a catastrophic medical episode like cancer, heart attack, or major surgery.
  • Patients with chronic diseases requiring continuous, costly medical care like heart disease, COPD, or diabetes.
Nicholas Newsad, MHSA is a senior analyst at a national healthcare management company. He holds a master's degree in hospital and health service administration from Xavier University. He lives in Westminster, Colorado.He has served as a senior healthcare analyst for six years and has also served as an interim surgery center administrator. He has been quoted and interviewed in the L.A. Times, NY Daily News, MSN Money, and Smart Money, as well as numerous other magazines, newspapers, and radio shows.

Do you have a horror story about your medical bills? Insurance company? Or medical provider? We want to hear about it. at medicalbillsurvivorsguide@gmail.com

Question: Question on charity

0 Comments - Posted by Nick Newsad on November 1, 2012 at 8:30 am
Thanks for the informative website and book!

I’m trying to help a friend who was recently diagnosed with cancer. She is uninsured. Initial emergency visit/hospitalization was $40,000. Then $140,000 for follow-up hospitalization and surgery. Now facing $6000+ per week for chemo. We’re filing for PCIP which hopefully will cover her going forward. But meantime, how to manage the $180,000+ bill? According to Methodist Hospital (Houston) finance counselor we talked to, their charity assistance isn’t for past treatments.  My friend would have to file an application and then wait 3-4 weeks for approval, and only then would care by covered, and only care from that date forward.  Furthermore, Methodist collects a lot of information on assets and my friends own some raw land worth few hundred thousand $.  However, their income is under 200% FPL and with friend no longer able to work, that will plummet, but Methodist insists that doesn’t matter, their assessment is based on income tax return (past income, not present).

Questions:

1.       Can they exclude past treatment from financial aid consideration and still maintain their tax exempt status as a non-profit?

2.       Can assets be included in the assessment (under Obamacare legislation) or only income?

3.       Can they not look at current income rate (practically $0) instead of looking at 2011 income tax return?

The raw land is worth money and eventually could be sold, but not now without a significant loss.  It isn’t a liquid asset.

Are there people who can help them sort all this out, help with the negotiation, etc.?  What are these people called so I know how to search for them?

Thanks,

Robert Johnston

 

Questions:
1.       Can they exclude past treatment from financial aid consideration and still maintain their tax exempt status as a non-profit?
I would push back on the counselor about excluding past treatments and request the account be frozen (no statement issued) until the charity care application is assessed.  Press the emergent nature of the services.  Escalate if necessary.
 
Challenging tax-exempt status is a big deal. They’ll have to contact the attorney general of Texas.
 
The most important issue they need to deal with first is to reach agreement with Methodist on the appropriate price (for example, what would the bill be if they were paying the same rates at United Healthcare or Blue Cross).  Once a price is established, then we have to figure out how to pay for it.  The $180,000 “gross charges” is akin to sticker price.  Not even the insurance companies have to pay that amount.
2.       Can assets be included in the assessment (under Obamacare legislation) or only income?
Methodist Hospital’s (Houston) charity care policies are attached.  They are pretty aggressive compared to other hospitals which mostly look at liquid assets (cash, stock, bonds).  Methodist also considers 1/2 the appraised value of non-primary residence assets (i.e., land which is not the primary residence would be included) compared to the social security administration’s asset tests for poverty.  I’ve never seen a hospital do this before (and I’ve seen alot).
 
The Affordable Care Act bans states from using asset tests for Medicaid eligibility.  This does not apply to hospitals.
 
For hospitals, the Affordable Care Act requires them to assess each patient according to their financial assistance policy, but Methodist has carved out non-liquid assets in their policy.  If Methodist pursues this, they will take your friends to court to liquidate their land.
3.       Can they not look at current income rate (practically $0) instead of looking at 2011 income tax return?
Yes, they can look at their current income.  I would escalate this, if they are not.The raw land is worth money and eventually could be sold, but not now without a significant loss.  It isn’t a liquid asset.
 Are there people who can help them sort all this out, help with the negotiation, etc.?  What are these people called so I know how to search for them?
I will help you.
You can skip to the end and leave a comment. Pinging is currently not allowed.

Leave a Reply

Your email address will not be published. Required fields are marked *

*

HTML tags are not allowed.