Financial Assistance

Summary of Health Care Financial Assistance Policy

Overview:
In accordance with our mission to provide people with disabilities the opportunity to achieve independence through rehabilitation, Mary Free Bed will provide medically necessary services, within its financial capabilities and constraints, to those individuals who have limited financial resources. It is the policy of Mary Free Bed to provide discounted rates and/or extended payment plans to those individuals needing assistance in paying for Mary Free Bed services. This is a summary of the Mary Free Bed Community Financial Assistance Policy.

Contact Info:
Phone: 616.840.8223
Fax: 616.840.9734
Email: financialcounselors@maryfreebed.com

Mary Free Bed Rehabilitation Hospital Provider Listing
The Mary Free Bed Community Financial Assistance Policy (FAP) is applicable to the following Mary Free Bed entities and all providers employed by these entities: Mary Free Bed Rehabilitation Hospital, Mary Free Bed Medical Group and Mary Free Bed Orthotics & Prosthetics.

Providers covered under this Financial Assistance Policy are:

  • Mary Free Bed Rehabilitation Hospital
  • Mary Free Bed Medical Group
  • Mary Free Bed Orthotics & Prosthetics

Other health care providers, including physicians, not employed by Mary Free Bed and delivering services within a Mary Free Bed entity or facility are not otherwise required to follow this Financial Assistance Policy.

Availability of Financial Assistance
Eligibility for financial assistance is determined by the ability of the patient or his/her guarantor to pay after all available resources have been utilized and all available assistance programs have been assessed. Financial assistance is available for medically necessary care provided by Mary Free Bed Rehabilitation Hospital, Mary Free Bed Medical Group and Mary Free Bed Orthotics & Prosthetics to uninsured and underinsured patients who are residents of the state of Michigan and whose family income does not exceed two and a half (2.5) times the Federal Poverty Guidelines (FPG).

Eligibility Requirements
Financial assistance is determined by a sliding scale of total household income based on the FPG. Individuals eligible for financial assistance under our policy with an income level at 145% FPG or below receive free care. Individuals with an income level from 146% to 180% FPG, 181% to 215%, and 216% to 250% FPG, respectively, receive discounted care based on a sliding scale, as set forth in the policy. The specific percentage discounts for the 146%-180% FPG, 181%-215% FPG, and 216%-250% FPG, income levels are updated annually with changes in the charge master.

No person eligible for financial assistance under the CFA policy will be charged more for medically necessary care than amounts generally billed to individuals who have insurance covering such care. If an individual has sufficient insurance coverage or assets to pay for care, he/she may be deemed ineligible for financial assistance. Please refer to the full CFA Policy for a complete explanation.

Application Process
The process for applying for financial assistance under our CFA Policy includes these steps:

  1. Complete the Community Financial Assistance Application and include required supporting documents.
    • We look at your income and family size to determine the level of assistance available to you. We use a sliding scale, based on FPG as outlined above.
    • We require that you first explore eligibility for some type of insurance benefits that would cover your care (i.e., Medicaid, Healthy Michigan, Workers Compensation, automobile insurance, etc.). We can help direct you to the appropriate resources.
  2. We will contact you to tell you whether you are eligible for financial assistance under our CFA Policy.
  3. We can help you arrange a payment plan for any remaining charges or bills that aren’t covered under our CFA Policy.
    • A payment plan will consider your financial situation to set payments that you can manage.
  4. Email the application to financialcounselors@maryfreebed.com or fax to 616.840.9734. Call 616.840.8223 with any questions
      • The Community Financial Assistance Application (CFA-3) should be completed by the patient, or the patient’s guarantor, and returned within seven (7) business days to MFB Patient Financial Counseling. Completion of this form is necessary to determine eligibility. Submission of documentation to support household income is required as the basis of eligibility determination
      • Applicants will be notified in writing of the decision regarding Community Financial Assistance within ten (10) business days of submitting a completed application. If an applicant is denied eligibility for CFA, an appeal of the denial may be submitted, in writing, within thirty (30) days of the denial date.  Once a written appeal is received, the application will be re-evaluated by Patient Financial Counseling.  A written response to the denial will be provided to the patient and will indicate the decision to approve eligibility for CFA or uphold the denial of CFA.
      • If a patient, or patient’s guarantor, is denied CFA, the patient or guarantor, may reapply at any time there has been a change of income or status.
      • Please return all applicable documentation along with the completed CFA-3 Application to the address on the envelope provided with your application, or to the address below:

Mary Free Bed Rehabilitation Hospital
Patient Financial Counseling
235 Wealthy St SE
Grand Rapids, MI 49503
(616) 840-8909

Basis for Calculating Amounts Charged
If a patient is eligible for financial assistance, the patient’s out-of-pocket expense will be determined by use by use of the Mary Free Bed Community Financial Aid Sliding Fee Schedule. Eligible applicants will receive the following assistance.

  • Full Free Care – Uninsured: The full amount of MFB charges will be determined covered under Community Financial Assistance for eligible services for uninsured patients, or patient guarantors, whose gross family income is less than 145% of the federal poverty guidelines and with assets totaling less than the equivalent of 600% of the Federal Poverty Guidelines threshold.
  • Discounted Care – Uninsured: A sliding scale discount will be provided for eligible services for uninsured patients, or patient guarantors, whose gross family income is equal to or greater than 145% FPG but less than 250% of the current federal poverty and with assets totaling less than the equivalent of 600% of the FPG threshold.

The balances due from uninsured patients will first be reduced according to Mary Free Bed’s Amount Generally Billed. Patients, or patient guarantors, eligible for Community Financial Assistance will be provided additional discounts according to the following schedule, based on the family income of the patient, or the patient’s guarantor:

  • Family income equal to or greater than 145% FPG but less than 180% FPG are eligible to receive an 80% discount on the patient balance due.
  • Family income equal to or greater than 180% FPG but less than 215% FPG are eligible to receive a 60% discount on the patient balance due.
  • Family income equal to or greater than 215% FPG but less than 250% FPG are eligible to receive a 40% discount on the patient balance due.

Collection Methods Taken in the Event of Non-payment:
Self-pay accounts will not be subject to bad debt collection actions within 120 days of issuing the initial self-pay, patient invoice and without first making reasonable efforts to determine whether that patient is eligible for Community Financial Aid.

Efforts to inform patients of Community Financial Aid will include a minimum of two statements noting the patient responsibility that is due and how to access information on Community Financial Aid. Regular phone calls will also be made to patients, or patient guarantors, if they have not resolved their bills or are not current on payment plans.

Mary Free Bed’s contracted self-pay vendor sends weekly e-mail notifications listing those accounts that have been uncollectible. The Patient Financial Services Supervisor will review the accounts, indicate his/her approval/disapproval, and will forward the e-mail to the Director of Revenue Cycle or the VP of Finance for approval to send the approved accounts to the collection agency. If all efforts to communicate with the patient, or patient guarantor, are unsuccessful, and a correct address for undeliverable mail is not found, accounts will be sent to a collection agency.

If a patient, or patient guarantor, applies for financial aid, no collection actions will be taken until an eligibility determination has been rendered. No collection actions will be pursued against a patient if the patient, or guarantor, has demonstrated that he or she has applied for coverage under Michigan Medicaid or other coverage programs, in the event that such programs will possibly pay the outstanding balance and for which an eligibility determination is still pending.

If an applicant is denied Michigan Medicaid or other coverage, or Community Financial Aid, appropriate steps must be taken by the patient, or guarantor, to resolve the outstanding self-pay balance or collection actions will be pursued. If an applicant is provided discounted care or medical hardship under Community Financial Aid, appropriate steps must be taken by the patient, or guarantor, to resolve the outstanding self-pay balance or collection actions will be pursued.

If a payment plan has been established and agreed to by the patient, or patient guarantor, and the patient or guarantor has defaulted on payment for at least 70 days, the account will be subject to bad debt collection actions.

Collection actions may be pursued by MFB after providing patients with a written notice, at least ten (10) days before the deadline specified in the notice, that informs the patient, or patient guarantor, of MFB’s authorized collection actions that may be taken if the individual does not submit a financial assistance application, comply with a payment plan, or fully pay the amount due.

Please click to download the following documents:
Community Financial Assistance Application (English)
Community Financial Assistance Application (Spanish)
Community Financial Assistance Policy Plain Language Summary (English)
Community Financial Assistance Policy Plain Language Summary (Spanish)
Community Financial Assistance Policy (English)
Community Financial Assistance Policy (Spanish)
Community Financial Assistance Sliding Fee Schedule for 2022 (English)
Community Financial Assistance Sliding Fee Schedule for 2022 (Spanish)