Patient advocate pressure on Mission, HCA leads to posting charity care application online
ASHEVILLE – Patient advocate pressure on HCA Healthcare paid off Nov. 17 when the company made a sample of its charity care financial assistance application public online at Mission Health’s website.
Mission may be the first of any HCA hospital system — there are more than 180 in its U.S. and United Kingdom network — to make this document immediately available to patients online.
The application is a two-page form qualifying patients can use to request medical bills be waived under HCA’s charity care policy.
More:Despite patient advocate asks, HCA's Mission yet to make charity care application public
The move comes following a partnership that started in July with leaders of WNC social media group Mountain Maladies and medical debt solutions organization Dollar For.
Mountain Maladies, a 13,500-member Facebook group founded and moderated by Western North Carolina resident Will Overfelt, requested Mission Health and its owner HCA make the application public so that local residents who wanted to apply for charity care could do so with ease.
Overfelt wanted to partner with Portland-based Dollar For, founded and led by Jared Walker, to utilize the organization’s free services helping patients “crush medical debt.”
When Overfelt in a Sept. 13 letter requested the application from Steve Gross with Parallon — which provides billing services for HCA — Gross responded but did not send the document.
Soon after, North Carolina State Treasurer Dale Folwell penned his own letter to Gross, reiterating Mountain Maladies and Dollar For’s ask.
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The Citizen Times also requested the application form and reported on the situation in an Oct. 31 article. HCA and Mission Health spokesperson Nancy Lindell responded to Citizen Times questions but did not send a copy of the application.
“While we are considering the merits of providing the application online, it’s important to note that our financial assistance process starts at the time care begins and we encourage conversations with our financial counselors so that we can help each individual find the assistance that is most helpful to their unique situation,” Lindell said Oct. 27.
But on Nov. 17, Lindell emailed Overfelt with a link to the application, which now is live on Mission Health’s website.
“I understand you reached out to Steve Gross recently and I wanted to follow up with my contact information,” Lindell said. “Please feel comfortable to contact me for any reason, I am happy to try my best to help. Regarding your request to Steve, a sample of our application has been posted on our website.”
The document is posted at www.missionhealth.org/financial-services/financial-support under a link titled, “Click here to view a sample financial assistance application.”
Before this document was posted online, patients who wished to inquire as to whether they were eligible for charity care had to call for a kind of screening interview with a “patient benefits advisor.”
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Having the application details in hand may simplify this process.
“It’s a small win but a win nonetheless,” Overflet said of the application’s posting. “Collaboration and compromise are possible even when different parties have very different perspectives. We won’t know if this will have a tangible benefit to citizens of WNC until we have a chance to help those seeking charity care submit an application on the form. But it is a step toward transparency and making the charity care process easier for the hard-working people of WNC who are struggling with huge medical bills.”
Overfelt encouraged WNC residents who need help with the charity care application to reach out to HCA directly or Dollar For help by visiting DollarFor.Org/Asheville.
Dollar For also can help patients with completing charity care applications at any other local hospitals such as AdventHealth or Pardee, he noted.
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Folwell praised advocates like Overfelt and noted the work of Take Medicine Back, which hosted a forum in July featuring the treasurer and other patient advocates including Walker.
“What I would say in the spirit of Tom Petty is that we're gonna go to the gates of hell before we ever back off transparency, quality and access to health care in Western North Carolina,” Folwell told the Citizen Times Nov. 18. “We have tried to get the law changed to bring the correct amount of transparency to these issues.”
As previously reported by the Citizen Times, Folwell has championed better charity care practices in the state, simultaneously condemning “failures” in the system. His office reported in January that some of North Carolina’s hospitals “have billed $149.2 million to poor patients who should have qualified for free or discounted charity care under the hospitals’ own policies in fiscal year 2019.”
Mission Health Financial Assistance Application Form by Andrew Jones on Scribd
More recently his office released another report that found “huge disparities between the Medicare losses claimed by hospital executives and the numbers that hospitals reported to the federal government.”
On Nov. 18 he said the “credit for this small step does do all of us who are singing from the same hymn book.”
HCA still thinks a phone call is better
The publication of this application on Mission Health’s website may be the first time the document has been made immediately available to the public by an HCA hospital system.
As of Nov. 18, for example, the financial assistance application was not posted to HCA’s TriStar Health website. TriStar is a network of 17 hospitals in Tennessee and Kentucky. HCA headquarters are located in Nashville, Tennessee.
The Citizen Times sent a series of questions to Lindell Nov. 17 regarding further publicization of the financial assistance application.
Those included:
Is the charity care application posted online for the Mission Health network the only application form posted by any HCA hospital? In other words, have any other HCA hospitals or hospital networks posted the application? Is the application available on HCA’s main website and, if so, how recently was it posted there? If not, will HCA post it there and at other hospitals?
What led Mission Health to post the application on its website?
Has Mission Health seen any noticeable uptick recently in charity care applications?
Lindell responded, but did not directly address some of these questions.
“We are always looking for ways to improve and a representative from our billing department received a request to have the charity care application posted online,” she said, noting the company continues to believe in the efficacy of a phone call over just turning an application in.
“In our experience with assisting patients over the years, a conversation with a Patient Benefits Advisor provides a more complete picture of a patient’s situation allowing us to identify solutions which help to determine eligibility for coverage that can often extend beyond their current care encounter. For instance, in North Carolina over the last year, our advisers helped more than 13,900 patient accounts be enrolled in longer-term coverage such as Medicaid.”
She added the company is “proud of the more than $277 million” it provided in financial assistance last year.
“We have not seen an increase in applications since the sample was recently posted.”
‘Lowest hanging fruit’
Charity care, according to the North Carolina Healthcare Association’s definition, is “services provided free of charge or at a substantial discount.”
Each hospital has different policies, and while nonprofits like Novant and AdventHealth are required to offer charity care in order to qualify for tax-exempt status with the federal government, for-profit hospitals like HCA are not.
Walker said Dollar For is already processing Mission Health financial assistance applications after the release of the application, but he’s worried his team and the applicants may run into more barriers.
“We have the application, we got them to post it on their site,” Walker said Nov. 18. “The question now is, will they accept applications here? If we start sending in applications, will they accept them and process them? Or will they still say, ‘You have to talk to a financial counselor before we even look at it?'”
There’s also the matter of how to submit the application. Walker said in a recent interview that many hospitals require applicants to fax or mail the documentation, an antiquated and cumbersome process.
Regardless, he said the information is helpful to a degree and encouraged HCA to post the application on the rest of its hospital websites.
“If you cared about the financial well-being of your patients, you would give them access to the lowest-hanging-fruit resource that you have to allow them to escape financial ruin because of medical debt,” Walker said.
Need medical debt help?
More information about whether Mission Health patients qualify for charity care or other financial assistance is available at missionhealth.org. Dollar For also helps patients figure out if they qualify and how to apply. Mission patients can start that process at dollarfor.org/asheville.
Andrew Jones is an investigative reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach him at @arjonesreports on Facebook and Twitter, 828-226-6203 or arjones@citizentimes.com. Please help support this type of journalism with a subscription to the Citizen Times.
This article originally appeared on Asheville Citizen Times: Mission charity care application public after patient advocates' push
