501(r) lessons learned - great lakes · powerpoint presentation author: kelly turner created date:...
TRANSCRIPT
![Page 1: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/1.jpg)
plantemoran.com
Aaron Fields, MHA
501(r) Lessons Learned
![Page 2: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/2.jpg)
plantemoran.com
Agenda
1. Introduction to 501(r)
2. Story Time with Aaron
3. A Dozen Lessons Learned
4. Pirates
5. Questions
2
![Page 3: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/3.jpg)
plantemoran.com
Introduction to 501(r)
• New IRS rule from the ACA
• December 29, 2015
• 4 Major Components
• CHNA
• Financial Assistance Policy
• Amounts Generally Billed
• Billing and Collections
![Page 4: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/4.jpg)
plantemoran.com
Primary Goals of Federal Policy Makers
Ensure patients and the
community at large are aware
that financial assistance is
available
FAP-eligible patients pay no more than the
average insured patient
Ensure patients & community
understand the process
Require tax-exempt hospitals
check FAP eligibility prior to undertaking any
ECAs
![Page 5: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/5.jpg)
plantemoran.com
Storytime
![Page 6: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/6.jpg)
plantemoran.com
A Dozen Lessons Learned #12 –Presumptive Eligibility: Inform your patients
![Page 7: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/7.jpg)
plantemoran.com
#11 - Signage
![Page 8: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/8.jpg)
plantemoran.com
#10 – Covered Provider List: Appendix and Group Names
Example:
ABC Hospital Client
• Exhaustive List of Covered and Non-Covered Individual Providers
• Resulted in an 18 Page Appendix to the FAP
Switched to Group Names
• Reduced Appendix Down to 4 Pages
• Reduces Long-Term Upkeep of the List
![Page 9: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/9.jpg)
plantemoran.com
![Page 10: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/10.jpg)
plantemoran.com
#9 – Documentation
![Page 11: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/11.jpg)
plantemoran.com
#8 – Headings for the FAP
Use Headings in FAP that match sections of 501(r)
1. Methods of Applying for Financial
Assistance
2. Eligibility Criteria
3. Limitation on Charges
4. Measures to Widely Publicize the
FAP
5. Actions that may be taken in the
Event of Non-Payment
![Page 12: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/12.jpg)
plantemoran.com
#7 – Add Language that Attests to Compliance
“ XYZ Hospital is in compliance with the 5-percent/1000 person threshold for translated copies the HHS Guidance safe harbor and 501(r) final regulations because there was not a population with English as a second language that met either threshold.”
![Page 13: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/13.jpg)
plantemoran.com
#7a – Translated Copies on your Website
![Page 14: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/14.jpg)
plantemoran.com
#7a – Translated Copies on your Website
![Page 15: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/15.jpg)
plantemoran.com
#6 – Review your 990 Schedule H Answers
![Page 16: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/16.jpg)
plantemoran.com
#5: Who does the AGB apply to?
OBAMACARE
![Page 17: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/17.jpg)
plantemoran.com
#5a: Who does the AGB apply to: Sample Calculation
Insurance 80/20 coverage Insurance 80/20 coverage
Deductible $2,000 Deductible $3,500
Hospital Bill $10,000 Hospital Bill $10,000
Deductible Paid $2,000 Deductible Paid $3,500
Remaining Bill $8,000 Remaining Bill $6,500
80% Insurance Payment $6,400 80% Insurance Payment $5,200
Remaining Patient Bill $1,600 Remaining Patient Bill $1,300
Total Patient Portion $3,600 Total Patient Portion $4,800
AGB Amount $4,500 AGB Amount $4,500
Result No Discount Result $300 Discount
We Care Hospital: AGB is 45%
Patient BPatient A
![Page 18: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/18.jpg)
plantemoran.com
#4 – Billing Collections and the FAP
• If Separate Policy – Reference in the FAP
• Also if Separate – House in the Same Location on Website
• Add a List of Relevant Definitions
• Describe Billing Process in Steps that Reflect Compliance
![Page 19: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/19.jpg)
plantemoran.com
#3 – Billing and Collections Timing
NOTIFICATION PERIOD 120 DAYS
240 DAYSAPPLICATION PERIOD
![Page 20: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/20.jpg)
plantemoran.com
#2 – Measures to Widely Publicize
![Page 21: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/21.jpg)
plantemoran.com
#1 – Education: Who needs to know?
![Page 23: 501(r) Lessons Learned - Great Lakes · PowerPoint Presentation Author: Kelly Turner Created Date: 9/22/2016 1:52:20 PM](https://reader035.vdocuments.net/reader035/viewer/2022071103/5fdcc6e785889074eb5b460e/html5/thumbnails/23.jpg)
plantemoran.com