Programa de asistencia financiera

Pautas básicas

Patients may apply for financial assistance from the date a patient is scheduled for service through the 365th day after the first billing statement is provided. However, eligibility for financial assistance only applies to emergency and other medically necessary care. Only United States citizens and residents of the United States are eligible for financial assistance. Financial assistance eligibility for non-emergency, medically necessary care is limited to patients residing in the service area defined in Attachment D of Baylor Scott & White's Financial Assistance policy, which includes all counties covered in BSWH Community Health Needs Assessments and otherwise where BSWH owns or operates licensed hospitals or provider-based clinics, as long as the facility providing the patient’s care is the closest facility (including non-BSWH affiliated facilities) to patient’s residence that can provide such medically necessary care or patient demonstrates that the closest facility cannot or will not provide such care. However, all patients, regardless of residency, will be eligible to qualify for financial assistance for emergency care and for non-emergency, medically necessary care provided after a BSWH facility accepts a transfer from a BSWH facility or a non-BSWH facility. Each eligible patient’s situation will be evaluated according to relevant circumstances, such as income or other resources available to the patient or patient’s family when determining the ability to pay the patient account balance.

Cuando las circunstancias de un paciente no satisfacen los requisitos de las Pautas de elegibilidad para el descuento de asistencia financiera o los Criterios de elegibilidad, un paciente con factores mitigantes inusuales aún puede obtener asistencia financiera. En estas situaciones, el Comité de Asistencia Financiera revisará toda la información disponible y tomará una determinación sobre la elegibilidad del paciente para asistencia financiera.

El paciente debe proporcionar información sobre el estado financiero del paciente y completar una solicitud para calificar para recibir asistencia. Si no cumple con los límites de ingresos y no puede pagar su factura, Baylor Scott & White ofrece un plan de pago extendido sin intereses para esos pacientes.

Please note: Except indicated in the BSWH Provider List (Attachment C) of Baylor Scott & White's Financial Assistance policy, the financial assistance offered under this Policy does not apply to services provided by any physicians or other professionals.

If you received services from a HealthTexas Provider Network (HealthTexas) physician, you may be eligible for Baylor Scott & White's Financial Assistance Program. For more information, please visit HealthTexas' website y read more about HealthTexas' financial assistance policy.

Determinación de asistencia financiera

Para saber si califica, proporcione la siguiente información durante el proceso de solicitud:

• Household Size¹
• Yearly Household Income², which must be verified by one or more of the following financial documentation (listed in order of preference):
• Pago cheque remesas
• W-2
• Declaración de salarios e impuestos
• Declaración de impuestos individual
• Verificación telefónica por parte del empleador del Ingreso Reportado del Paciente
• Remesas de pago de la Seguridad Social
• Remesas de pagos de compensación al trabajador
• Aviso de pago de seguro de desempleo
• Cartas de determinación de la compensación por desempleo
• Prueba de participación en programas de asistencia gubernamental tales como cupones de alimentos, Programa de Salud Indigent del Condado (CDIC), Ayuda a Familias con Niños Dependientes (AFDC), Medicaid, Mujeres, Infantes y Niños (WIC), o Asistencia Temporal para Familias Necesitadas (TANF) ), Asociación TexCare
• Estados de cuenta bancarios
• Respuesta de una consulta de crédito
• U otros indicadores apropiados del ingreso informado del paciente

¹Adults: In calculating the Household Size, include the patient, the patient’s spouse, and any dependents (as defined by the Internal Revenue Code (IRC)).

Menores: al calcular el tamaño del hogar, incluya al paciente, la madre del paciente, el padre del paciente, los dependientes de la madre del paciente y los dependientes del padre del paciente.

²Adults: If the patient is an adult, “Yearly Household Income” means the sum of the total yearly gross income or estimated yearly income of the patient and the patient’s spouse.

Menores: Si el paciente es menor de edad, el "Ingreso familiar anual" significa la suma del ingreso bruto anual total o el ingreso anual estimado del paciente, la madre del paciente y el padre del paciente.

Financieramente indigente

"Económicamente indigente" significa un paciente cuyo ingreso familiar anual es menor o igual al 200 por ciento de las pautas federales de pobreza ("FPG"). Estos pacientes financieramente indigentes son elegibles para un 100% de descuento en los saldos pendientes de la cuenta del paciente según el Anexo A (ver a continuación) de las Pautas de descuento de elegibilidad de asistencia financiera (Anexo B) de la política de asistencia financiera de Baylor Scott & White.

Ejemplo: un paciente con un tamaño de hogar de 3 y un ingreso familiar anual de $36,620 es elegible para un descuento de asistencia financiera de 100%.

Planificar una

Basado en las Pautas Federales de Pobreza emitidas 1/19/2024

Clasificación de indigencia financiera

Médicamente indigente

"Medically Indigent" means a patient whose medical or hospital bills from all BSWH related providers, after payment by all third parties, exceed 5% of his or her Yearly Household Income, whose Yearly Household Income is greater than 200% but less than or equal to 500% of the FPG and who is unable to pay the outstanding patient account balance. These Medically Indigent patients will owe the lesser of the patient’s account balance or 10% of the patient’s gross charges not to exceed the calculated AGB amount as described in Section 4 of Baylor Scott & White's Financial Assistance policy.

Example: A patient with a Household Size of 4 and Yearly Household Income of $85,000 (between 200 - 500% of FPG) is eligible for a financial assistance discount down to the lesser of the patient’s account balance or 10% of gross charges not to exceed the calculated AGB amount if the patient’s total outstanding bills, after all third-party payments, are equal to or greater than 5% of the Yearly Household Income. Assuming the patient’s gross charges is $50,000 and account balance is $10,000 (which is equal to or greater than 5% of the Yearly Household Income) and the calculated AGB amount is $15,000; the patient’s remaining obligation would be $5,000. Please note, if the patient’s remaining balance is already less than 10% of gross charges or the calculated AGB amount, the patient will receive no additional fee reduction and will be responsible for paying the remaining balance.

Horario B

Basado en las Pautas Federales de Pobreza emitidas 1/19/2024

Clasificación Médicamente Indigente