Financial Assistance Application | Provider Listing | Federal Poverty Income Guidelines
Western Reserve Hospital is committed to providing education to patients and guarantors as it relates to billing and collections of payment for services rendered. Payment on accounts will be pursued consistently, regardless of race, age, gender, ethnic background, national origin, citizenship, primary language, religion, education, employment or student status, disposition, relationship, insurance coverage, community standing, or any other discriminatory differentiating factor. To that end, Western Reserve Hospital will not engage in any extraordinary collection actions (as defined herein) against an individual to obtain payment for care before reasonable efforts have been made to determine whether the individual is eligible for assistance for the care under its Healthcare Financial Assistance (“HFA”) Policy.
Every guarantor will be given reasonable time and communication to be aware of and understand their financial responsibility. The guarantor will be held financially responsible for services actually provided and adequately documented. Western Reserve Hospital representatives and/or its designee will widely publicize its HFA policy by, among other things, offering a copy of the plain language summary of the policy prior to the patient being discharged. Understanding each guarantor’s insurance coverage is the responsibility of the guarantor. Any self-pay liability secondary to insurance coverage is defined by the guarantor’s insurance coverage and benefit design. Western Reserve Hospital relies on the explanation of benefits and other information from the guarantor and the insurance carrier for eligibility, adjudication of the claim, and patient responsibility determinations.
Western Reserve Hospital offers various options for uninsured and underinsured patients who do not qualify for financial assistance under its HFA policy. For further information, please see the following Western Reserve Hospital policies, or contact Western Reserve Hospital as indicated on Page 5:
• Western Reserve Hospital Healthcare Financial Assistance Policy
• Western Reserve Hospital Financial Aid Catastrophic Policy
A statement of hospital services is sent to the patient/guarantor in incremental billing cycles. In cases when the patient has no insurance coverage, that is a self-pay patient, the statement is sent after services are rendered. In most cases when patients have coverage through an insurance carrier, the statements are sent after the services have been rendered, claim is submitted, and claim has been adjudicated by the insurance carrier. There are some cases, for example, when there is a stop in the adjudication of a claim due to the patient needing to provide additional information, where a statement will be sent to the patient and/or guarantor prior to claim processing.
Western Reserve Hospital representatives and/or their designees may attempt to contact the patient/guarantor (via telephone, mail, or email) during the statement billing cycle in order to pursue collections. Collection efforts are documented on the patient’s account.
The statement cycle will be measured from the first statement sent to the patient (date sent) and include the following:
Subsequent statements sent to the patient/guarantor in increments to derive at the statement process:
Extraordinary Collection Actions (ECAs):
Efforts to Determine HFA Eligibility:
Processing HFA Applications:
If an individual submits an incomplete HFA application during the application period, Western Reserve Hospital will:
If an individual submits a complete HFA application during the application period, Western Reserve Hospital will:
If the individual is determined to be HFA-eligible for the care, Western Reserve Hospital will:
When no HFA application is submitted, unless and until Western Reserve Hospital receives a HFA application during the Application Period, Western Reserve Hospital may initiate ECAs to obtain payment for the care once it has notified the individual about the HFA policy as described herein.
Anti-Abuse Rule – Western Reserve Hospital will not base its determination that an individual is not HFA-eligible on information that Western Reserve Hospital has reason to believe is unreliable or incorrect or on information obtained from the individual under duress or through the use of coercive practices.
Determining Medicaid Eligibility – Western Reserve Hospital will not fail to have made reasonable efforts to determine whether an individual is HFA-eligible for care if, upon receiving a complete HFA application from an individual who Western Reserve Hospital believes may qualify for Medicaid, Western Reserve Hospital postpones determining whether the individual is HFA-eligible for the care until after the individual’s Medicaid application has been completed and submitted and a determined as to the individual’s Medicaid eligibility has been made.
No Waiver of HFA Application – Obtaining a signed waiver from an individual, such as a signed statement that the individual does not wish to apply for assistance under the HFA policy or receive the notifications described herein, will not itself constitute a determination that the individual is not HFA-eligible.
Final Authority for Determining HFA Eligibility – Final authority for determining that Western Reserve Hospital has made reasonable efforts to determine whether an individual is HFA-eligible and may therefore engage in ECAs against the individual rests with the Western Reserve Hospital Patient Financial Services Department.
Agreements with Other Parties – If Western Reserve Hospital sells or refers an individual’s debt related to care to another party, Western Reserve Hospital will enter into a legally binding written agreement with the party that is reasonably designed to ensure that no ECAs are taken to obtain payment for the care until reasonable efforts have been made to determine whether the individual is HFA-eligible for the care.
Providing Documents Electronically – Western Reserve Hospital may provide any written notice or communication described in this policy electronically (for example, by email) to any individual who indicates he or she prefers to receive the written notice or communication electronically.
Financial counselors are available to answer your questions about payment arrangements, insurance coverage, Medicare and other financial inquiries.
For more information about financial counseling, please call:
Contact Western Reserve Hospital Patient Account Services at (330) 255-3101.
Representatives are available Monday through Friday from 8:00 a.m. to 12:00 p.m. and from 1:00 p.m. to 4:30 p.m.
Notice to Ohio Residents—Ohio Hospital Care Assurance Program (HCAP): Western Reserve Hospital provides, without charge to the individual, basic, medically necessary hospital-level services to individuals who are residents of Ohio, are not Medicaid recipients, and whose income is at or below the federal poverty line. Covered services are inpatient and outpatient services covered under the Ohio Medicaid Program, with the exception of transplantation services and services associated with transplantation. Recipients of Disability Financial Assistance qualify for assistance. Ohio residency is established by a person who is living in Ohio voluntarily and who is not receiving public assistance in another state. Requests for financial assistance for Ohio residents are processed for HCAP first, and then are otherwise subject to the provisions of this HFA policy.