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Charity Care/Financial Assistance

Purpose:

Cordell Memorial Hospital is committed to provide charity care to persons who have healthcare needs and are uninsured, underinsured, ineligible for a government program or otherwise unable to pay for medically necessary care based on their individual financial situation.

Policy:

Charity is not considered to be a substitute for personal responsibility. Patients are expected to cooperate with the procedures for obtaining charity care. All patients should be treated fairly, with dignity, compassion and respect.

It is the responsibility of Cordell Memorial Hospital to respond to all patient requests for charity eligibility during any one or more patient interactions; namely preregistration, registration and discharge. 

The granting of charity care shall be based on an individualized determination of financial need and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation.

It is the responsibility of the patient to actively participate in the financial screening process.

To be eligible for charity care the patient’s family income may not exceed 200% of the Federal Poverty Guidelines established by the Department of Health and Human Services.

Presumptive Eligibility:

Individuals who are uninsured may be considered eligible for the most generous financial assistance in the absence of a completed Financial Assistance Application (FAA) if:

  • Individual is homeless
    • Individual is deceased and has no known estate able to pay hospital debts
    • Individuals who filed bankruptcy. We must have received a letter from the court.
    • Individual has received Medicaid benefits. Service dates for up to six months to the Medicaid qualification and six months past the Medicaid eligibility date will be considered for Financial Assistance.

Financial assistance may consist of:

  • Full Adjustment of the self-pay balance
  • Partial Adjustment of the self-pay balance


If a patient’s account is in Bad Debt status when charity care eligibility is determined, that account will be returned to active status and charity benefits applied.

From the date of eligibility determination, Charity Care can go back 6 months to encompass previous dates-of-service as well as forward 6 months for any future dates-of-service.

Procedure For Filing for Charity Care/Financial Assistance:

Patient, patient’s guarantors or their representative may request Financial Assistance Application from a Business Office Representative at which time they will be given a Financial Assistance Application at no cost to the patient.

  • Patients have 6 months from date-of-service to request financial assistance. After 6 months financial assistance is not available for that date-of-service.
  • All patients, guarantors or representatives who receive a Financial Application must return it to the Cordell Memorial Hospital Business Office Representative within 10 working days of receiving the application.


Once an application has been received by the Business Office Representative it will be reviewed and compared with the yearly Federal Poverty Guidelines, which includes income and number of family members in the home, to determine eligibility.

Once application has been received and reviewed, patient will be notified by Cordell Memorial Hospital Business Office Representative in writing within 10 business days of eligibility or denial.

Cordell Memorial Hospital provides charity care based on the following sliding scale:

Federal Poverty LevelAt or Below 150%175%200%Above 200%
Financial AssistanceYou pay $0You pay 50%You pay 80%You pay 100%

Collection Activity:

If an account is eligible for a partial write-off but the patient fails to cooperate with the financial assistance process, or if the patient is not eligible for financial assistance, collection activity will be considered.

Confidentiality:

Cordell Memorial Hospital will uphold the confidentiality and individual dignity of each patient. Cordell Memorial Hospital will meet all HIPAA requirements for handling personal health information.