Wyoming Medical Center plans to administer an easier application process for charity care patients, according to Nancy Brandt, chief financial officer. Of about $30 million in uncompensated care provided by the Casper, Wyo.-based health care group each fiscal year, about 20% is from charity care patients and 80% is from "bad debt" patients.

Nationally, the split between charity care and bad debt patients is about 50%, Brandt says.

"We really want to go back and make sure that we're treating all of our patients in the most fair and equitable way we can and being a good community partner and categorizing them appropriately," she says. "So for people who are truly needy, we wanted to have a policy that would allow them forgiveness on their debt related to their medical bill."

The old charity care application was a lengthy, five-page long process that took about an hour to complete and didn't provide information that was particularly helpful in making the charity care qualification determination, she says. "This policy won't change the financial implication to Wyoming Medical Center," Brandt says. "The $30 million we spend every year won't change. What will change is how those patients' charges are classified."

Charity care happens when a person applies and the hospital determines that the person is unable to pay his or her bill, while bad debt occurs when a person simply does not pay his or her bill for whatever reason.

Working with Healthcare Financial Management Association, a charity care policy development firm, the medical center chose a new version of the application based on federal guidelines and comparability to other hospitals nationally. "We also wanted to take out the pieces of the policy where it felt like we may be judging a patient," Brandt says. "We wanted to eliminated that and base it just on the facts related specifically to their tax forms, then to pay stubs and things that can be verified by documentation."

The new application is one page and will take about five minutes to complete. Based on a sliding scale, the improved charity care policy will enable patients at 200% or less of the poverty guideline - known as the "medically indigent" -- to apply for complete coverage of their medical bills. The scale also allows patients up to 275% of poverty level coverage for a percentage of bills.

"We still expect people who might qualify for Medicare or Medicaid to do that application process. We still expect people who have insurance to show us that and use that insurance, and we still expect people who have an ability to pay to pay," Brandt says.

Due to the federal government's recent concentration on proving the viability of nonprofit organizations, the new charity care application will enable better categorization of uncompensated funds and will help the medical center prove its nonprofit status, hospital officials say.

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