Ocean Beach Hospital and Medical Clinics have a Financial Assistance / Uncompensated Care Policy. This policy contains the guidelines for patients to follow if they need any assistance with payment of their hospital bills. This policy applies to those who do not have insurance AND those who have insurance and is based on income levels. Please ask at the admitting area or the Business Office for a copy of the guidelines and an application. Completed applications should be sent or delivered to the Business Office.
Hospitals which are nonprofit and recognized as 501(c)(3) organizations (including Public Hospital District 3 of Pacific County) shall limit amounts charged for emergency or other medically necessary care provided to individuals eligible for assistance under this Financial Assistance policy to not more than the amounts generally billed to individuals who have insurance covering such care and may not collect “gross charges” from such individuals. See requirements WAC246-453-040 and WAC 246-453-050 and IRS 501(r). All individuals receiving services are charged the same amount per the prospective method of charging. All services are charged and billed utilizing a hospital chargemaster and CMS coding guidelines. This financial assistance update is effective beginning January 1, 2018.
To apply for financial assistance a completed application, including all required documentation must be returned to the Ocean Beach Hospital Business Office. The required documentation is listed on the application.
Our Financial Assistance / Uncompensated Care program is based on a sliding fee schedule extending up to 300% of the federal poverty level. In order to qualify you must meet the following criteria:
- Be a resident of Pacific or Wahkiakum counties or if residing outside of Pacific or Wahkiakum counties, services must have originated in the Emergency Department;
- Catastrophic Financial Assistance is available and may be granted even if you do not qualify under the Federal Poverty Level guidelines;
- All services must be medically necessary as defined by the ordering or treating provider;
- Elective services are not covered under our Financial Assistance Policy or the 501(r) requirements;
- Experimental treatments, cosmetic procedures, and transportation costs are excluded from financial assistance and are the responsibility of the patient;
- Complete the Financial Assistance / Uncompensated Care application; and,
- Provide all documentation requested.
After all criteria have been met, a determination will be made based on income and asset information.
You may qualify for a discount of up to 100 percent of your bill.
Financial assistance will be approved for a 6 month time period. At the end of the approved time period, you will be required to reapply with updated information. Only medically necessary charges qualify for financial assistance.
Financial arrangements must be made prior to admission for any prescheduled services. For those with insurance coverage, payment of co-payments and deductibles are expected at the time of service. If payment arrangements are needed, they must be set up within 120 days from the date of the first statement. Payment arrangements are required whenever the bill cannot be paid in full at the time of the first billing statement. The guarantor is responsible for making appropriate financial arrangements with the Business Office. Ocean Beach Hospital offers a three-month in-house payment plan.
Ocean Beach Hospital and Medical Clinics have partnered with AccessOne Financial to provide a solution for those who need a longer-term to pay. AccessOne Financial offers terms of 6-60 months with payments as low as $25 per month. Please take note that any accounts returned by AccessOne Financial for non-payment will not be eligible for additional payment plans.
To prevent collection activity please apply for financial assistance or payment plans within 120 days of your first statement. Unpaid accounts will be submitted to a collection agency 120 days after the first statement to the patient. Your account will continue to age until the completed financial assistance application is returned to the Business Office for processing. Once the account is turned over to a collection agency it is no longer eligible for financial assistance or payment plans.
For services that are the result of a work-related injury the Business Office will need the following information:
- Employer name, address, and phone number;
- Date of Injury; and,
- Claim number, if applicable.
You must notify your employer of an on-the-job injury. Your employer will need to submit additional information to the industrial carrier. Ocean Beach Hospital Emergency Room physicians cannot assist you with re-opening a closed claim. You will need to go to your primary care physician for all follow-up services.
For services related to a motor vehicle accident, the Business Office will submit a bill on your behalf once the following information is received:
- the name of the responsible party;
- the name, phone number and billing address of the responsible party’s insurance carrier and agent’s name;
- the guarantor’s auto insurance company name, phone number, billing address and agent name; and,
- any claim numbers assigned to you for this particular accident.
Ocean Beach Hospital & Medical Clinics will not wait for litigation with regard to an accident. It will be your responsibility to pay the bill in a timely manner if insurance does not pay timely.
Ocean Beach Hospital and Medical Clinics will bill your insurance company if all needed information and a copy of your insurance card are presented at the time of registration.
At the time of registration, you will be asked to sign a form authorizing your insurance company to assign insurance benefits to Ocean Beach Hospital and Medical Clinics. You are expected to pay for charges that are not covered by insurance such as co-payment, co-insurance, non-covered, and deductible amounts. Questions regarding insurance coverage or benefits must be directed to your insurance company. It is your responsibility to know and meet the requirements of your insurance policy for pre-approval of your hospital service(s).
If you have questions relating to a provider’s preferred, participating network, or non-network status, please refer to those questions to your insurance company. The patient is responsible for meeting the requirements of their insurance policy and all questions regarding insurance coverage or benefits must be directed to your insurance company.