Financial Assistance -- Plain Language Summary
Patient’s
Obligations
and
Rights
regarding
Hospital
bills
For patients with the ability to pay, it is their obligation to pay their
bill in a timely manner. If they fail to meet this obligation, they may
be referred to a collection agency. If a patient believes they have been
wrongly referred to a collection agency, they have the right to contact
the hospital for more information at
410-641-9101. If a patient is uninsured or underinsured, financial assistance (FA)
may be available. There are certain criteria that must be met in order
to qualify for FA. If a patient applies for FA, it is their responsibility
to provide all required information and supporting documents to the hospital
so that their eligibility can be determined. Partial or full financial
assistance will be granted based on the patient’s ability to pay
the billed charges. The information below summarizes Atlantic General
Hospital’s Financial Assistance Policy. For more information regarding
FA, please call
410-629-6025 or visit the AGH website:
http://www.atlanticgeneral.org/fap
Overview
It is the policy of Atlantic General Hospital/Health System to provide
medically necessary services without charge or at a reduced cost to all
eligible persons, who are unable to pay, according to the Hospital’s
guidelines. Atlantic General Hospital defines all emergency room care
as medically necessary even though decisions by insurance companies may
be in conflict with this decision.
A FA eligible individual may not be charged more than the Amounts Generally
Billed (AGB) for emergency or other medically necessary care. Eligibility
for financial assistance is based on several factors, including income
(see Federal Poverty Level guidelines below), household size, assets and
any special consideration that the patient would like to have considered.
Patients may be eligible for Medical Assistance or other public assistance.
Patients can apply at their local Department of Social Services or online.
Information and applications can be obtained from the following state
websites:
https://mmcp.dhmh.maryland.gov (MD),
http://dhss.delaware.gov (DE),
http://www.dmas.virginia.gov (VA). Maryland residents might be able to apply for assistance with MD
Children’s Health Program if the assistance is for a child or a
pregnant woman. Patients may also apply for Qualified Medicare Beneficiary
(QMB) or Specified Low Income Medicare (SLMB) programs if they need assistance
with Medicare premiums.
Physician
services
provided
during
your
stay
will
be
billed
separately
and
are
not
included
on
your
hospital
billing
statement.
Am
I
eligible?
AGH bases Financial Assistance on the patient’s income level falling
within these ranges:
- 0% to 200% of the Federal Poverty Guideline - 100% reduction for Medically
Necessary care
- Between 201% and 225% of the Federal Poverty Guidelines - Reduced cost
Medically Necessary care at 75%
- Between 226% and 250% of the Federal Poverty Guidelines - Reduced cost
Medically Necessary care at 50%
- Between 251% and 300% of the Federal Poverty Guidelines - Reduced cost
care Medically Necessary care at 25%
An application is deemed eligible for 100% Financial Assistance if a patient
is enrolled in a means tested program such as:
- Reduced/free school lunches
- SNAP (food stamps)
- MEAP (energy assistance)
- WIC
There are other circumstances where Financial Assistance may automatically
apply. Please contact
410-629-6025 for more information.
How
can
I
apply?
The uniform financial assistance application can be found online at:
http://www.atlanticgeneral.org/fap. This application can also be obtained at any Atlantic General Hospital
Registration area (9733 Healthway Drive, Berlin, MD 21811) or the Patient
Accounting Office (10026 Old Ocean City Blvd, Unit 6, Berlin, Maryland
21811). This form, the FA application and FA policy are available upon
request and free of charge. These forms are also available in Spanish
and Large Print.
Click here for a printer-friendly version of the Financial Assistance Plain Language Summary.