Myc lye

Chin' h sich ha trg tai &L b. cua BIDNIC 2 Ap dung 2

Tham khio 2

Muc dish 2

Cic kha niem 3

Cic dich vu du dieu kien Ho trig tai chinh 7

Cic dich vu du khOng du dieu kien HQ trig tai chinh 7

Dinh gii nhu cau sire khae ctia cOng dtng 7

Cie c.huong trinh he trig cOng &tag 9

1ft trig tai chinh benh vien qua Health Safety Net 9

Val tre cua co N4/3. ho trig tai chinh 12

Nghia vu cda benh nhin 13

Cic tieu chuan hg trig tai chinh benh \ion 14

Giam gii hi trg tai chink 17

Chinh sich ha trig taxi chinh 17

LST do tir chtti 19

Dieu lden khoin 19

Cic dich vu cap ciru y to 20

St den thong thtiong thanh town (AGB) 20

Chinh sich thanh town vi truy thu 20

Yeu ciu dieu chinh 20

Phu. luc 1 21 ML long kST Trg cap tai chinh 21

Phu luc 2 24 Dan ding kv trig cap kh6 khan y to 24

Phu luc 3 27 Bieu 6 intic giam gii dua tren thu nhip 27

Phu Itic 4 28 Nhi cung cap dish vu bio hiern vi y to 28

Phu luc 5 29 SO tien thong thuong thanh town (AGB) 29

Phu luc 6 30 Tray cap tat lieu 30

Lich sir cita chinh sich 31

c uLi cz,f, .

Chinh such h6 tro, tai chinh cua BIDMC

Ap thIng Chinh such nay ap dung cho Trung tam y to Beth Israel Deaconess (BIDMC) va cac nha cung cap dich vu y to do BIDMC thue hoac la hOi vien cua BIDMC (xem Phu luc Bon (4): danh such cac nha cung cap dich vu Ai) dung chinh such nay).

Tham khao EMTALA: Tuyen tap cac thong tin tai chinh Chinh such Bao lanh tin dung va Uy tilde nhat. thu Dinh mire ngheo kh6 Lien bang, BO Y to va Dich vu Nhan sinh Hoal(5/ Thong bao IRS 2015-46 va 29 CFR §§1.501(r) (4)-(6) Phu luc 1: Mau clang ky Trg cap tai chinh Phu luc 2: Dcm clang 14 tip cap y to cho nguoi ngheo Phu luc 3: Bieu do mirc giam gia dua ten thu nhap Phu luc 4: Nha cung cap dich vu bao hiem va y to Phu luc 5: S6 tien thong thuOng thanh town Phu luc 6: Truy cap tai lieu

Muc filch Sir mang cua chimg toi la tao su khac biet thong qua su xuat sac trong viec chum soc benh nhan, gido duc, nghien ciru va thong qua no tkrc cai thien sirc kh6e Ong (long tai not ma chimg toi phuc vu.

BIDMC luon no luc cung cap cac ht; trg tai chinh cho benh nhan — nhimg ngtriri co nhu cau chum soc sire khoe nhung khong c6 bao hiem, khong du bao hiem dit dieu kien tham gia cac chtrang trinh cua Chinh phit, hoac la kh6ng du kha nang chi tra cho cac nhu cau chum soc y to do hoan canh tai chinh. Chinh such ha trg tai chinh nay phu hop viri luat phap Lien bang va bang ap dung tai khu vuc cua chimg toi. Cac benh nhan du lieu chuan nhan ho to. tai chinh se thrgc giam gia khi chum soc sirc khOe tai cac nha cung img dich vu thuOc BIDMC.

Ho trg tai chinh dugc cung cap theo chinh such nay chrgc thu .c hien vai hi vong nhan dtrot sir hO trg tir phia benh nhan trong qua trinh ap dung va t nhimg chtrang trinh phiic lgi hoac bao hiem sun c6 de c6 the trang trai chi phi chum soc sirc khoe.

Chung toi se 'thong phan biet tuOi, gigi tinh, chimg Vic, tin nguang, ton gido, khuyet tat, giai tinh, giai , quoc tich goc hay tinh trang di till khi xac nhan mot benh nhan la thich hop hay khong thich hop vo.i chinh such.

Trung tam Y to Beth Israel Deaconess Chfnh such ho tra tai chfnh Trang 2

Cac khai niem Cac dinh nghia sau day dirgc dung cho tat ca cac muc dm chinh sach nay.

Phan loci dich vu khan cap hay khong khan cap dua tren cac khai niem chung ben cluei cling nhu xac nhan cita bac si dieu tri. Cac khai niem ve dich vu cham soc cap ciru hay khan cap dual day con &roc dung O. cac benh vien, vai muc dich xac dinh co nen cho phep nq xau trong trtrang hop cap ciru hay khan cap theo chuong trinh ho tra tai chinh dm benh vien, g6m ca. Mang ltrot an toan sirc khoe.

SO tien thong thulYng thanh toan (AGB): la so tien dugc ky vong &roc benh nhan va/hoac ngtrai bao lanh thanh toan cho viec cap ciru hoac cac dich vu y te. Vai cac benh nhan dap O ng diet' kien, so tien nay khong vuot qua mat ty le dugc xac dinh bang cach ding Phuong phap hoi ciru — dtroc ma to trong muc 1.501(r)-5(b)(3) dm BO luat ye ngat} sach lien bang. Phucmg phap nay dua tren dir lieu thuc to chi tra cho BIDMC bai Medicare Fee For Service (phi dich vu trong Medicare) ding voi chi tra tit cac cong ty bao hiem y to to nhan.

Yeu cau throe dua vao tinh toan dm AGB se dtrgc yeti cau cho pile') trong nam duang lich ke trtrac. S6 tien (long bao hiem, dong chi tra hoac ltrcmg khautrir se &roc tinh a mau so cling vai Medicare Fee For Service ben canh voi tat ca cac yeu cau cho phep tir cac nha bao hiem y to to nhan. Tong chi phi se la mau so. AGB se &roc fifth toan hang nam vao ngay thir 45 sau khi ket thuc nam throng lich truck, va dtrac dux hien vao ngay thir 120 sau khi ket thfic nam throng lich.

Ty re' so tien thong thuirng ducrc tinh: Ty le nay throc tinh hang nam vao ngay thir 45 dm nam va dtrgc ma to trong Phu luc Nam (5) dm chinh sach nay.

Thai gian Op dun: La khoang thai gian trong do la don se dirge chap nhan va xem xet de ho to tai chinh. Thai gian nap don bat dau tir ngay c6 thong bao chi tra sau khi xuat vien va ket thitc vao ngdy thir 240 sau ngay do.

Tat sin: Bao Om: • Tai khoan tiet kiem • Tien mat • Tai khoan tiet kiem y to (HSA)* • Tai khoan bOi hoan y to (HRA)* • Tai khoan lith hoat chi lieu (FSA)*

*Viec giam chi phi c6 the khOng ducyc tip dung neu benh nhan/nguoi bao lanh có HAS, HRA, FSA hoac khoan tuong to &roc chi dinh dung cho cac chi phi y to dm gia dinh. Viec chi tra tir cac khoan khac truac khi giarn gia c6

Trung tam Y te Beth Israel Deaconess Chinh sach hO troa tai chinh Trang 3

the sir dung. Tinh trang cap cti•u y te: Nhu dinh nghia trong muc 1867 cua Dao luat an sinh xa hei (42 U.S.C. 1395dd), thuat ngit "Tinh trang y to khan cap" c6 nghia la met tinh trang benh 151 bieu hien bang the trieu chi:mg cap tinh vai mire de nghiem trong ma neu khong c6 cham soc y to se c6 the an den nhung hau qua:

1. Lam sirc khoe cua ca nhan (hoac, dac biet la phu nu mang thai, sire khoe cua thai phu va thai nhi) trong tinh trang nguy hiem nghiem trong.

2. Ton hai nghiem trong den chirc nang cua co the 3. Rei loan nghiem trong chirc rang met phan. hay toan be co the 4. Dac biet doi voi phu nu chuyen da:

a. Khong du thai gian chuyen den benh vien khac met each an toan de phuc vu cho viec sinh

b. Viec chuyen den vien c6 the de doa sire khoe va su an toan cua ba me va thai nhi.

Tien nhan chon loc: Viec nhap vien khong dugc xem xet la Tinh trang cap cum hay thong thuang kh6ng dugc dp dung chinh sach nay.

Gia dinh: theo dinh nghia cua Co quan thong ke dan s6 Hoa 1(y, la met nhom tir hai nguai tra len cling sinh song vai nhau, co quan he huyet thong, lion than hoac nhan nuoi. Neu met benh nhan cho rang ai dO dugc bao hi) bang thue thu nhap cua ho, theo Sor Thue vu, h9 se dugc xem xet xem c6 du dieu kien huang chinh sach nay hay khong.

Thu nhap cua ho gia dinh: Thu nhap gia dinh throng dan la tong thu nhap gan nhat dugc khai vao thue lien bang cua tat ca moi ngued da thanh nien trong gia dinh, sinh song trong met he gia dinh. Vai benh nhan duai 18 tu6i, thu nhap cua hi) gia dinh bao gem thu nhap cua cha/me, hoac cha me, va/hoac cha/me ke, hoac ngued cham soc la than nhan. Thu nhap cua ho gia dinh dugc xac dinh theo Ca quan thong ke dan so Hoa KS/, gem cac khoan thu nhap sau dugc tinh theo Dinh mire ngheo kho lien bang: ,

1. Gem thu nhap, try cap that nghiep, fro . cap lao deng, an sinh xa hei, tien trg cap an sinh, trg cap xa hei, tien cuu chien binh, try cap cho nhitng nguori song sot, lucmg huu hoac thu nhap khi nghi htru, lai suat, co tire, lien thue, tien ban quyen, thu nhap tir bat deng san, tin tilde, tien sinh hoat phi gido due, tien cap dueng va h6 fro. tre em

2. Trg cap khong sir dung tien mat (ram phieu thuc pharn hoac fro. cap nha a) khong dugc tinh

3. Thu nhap dugc tinh truac thue 4. Khong bao gem tang von va cac khoan to

Mtic ngheo WA lien bang (FPL): Sir dung ngu'emg thu nhap — phu thuec vao quy mo va thanh phan cua ho gia dinh — de xac dinh ai la ngtrai ngheo a Hoa Ky. Mire nay dugc cap nhat dinh lcSr trong Dang ky lien bang boi BO Y to va

Trung tam Y te" Beth Israel Deaconess Chinh sach 118 tar tai chinh Trang 4

cac (Lich vu nhan sinh Hoa KS' theo quy dinh cua Khoan (2), Muc 9902, Chuang muc 42 cua Dao luat lien bang. Tham khdo huang an hien tai ve FPL qua &rang dAn https://aspe.hh.s.gov/poverty-guidelines.

HO try tai chinh: su he; trg cho cac benh nhan du dieu kien, nhang nguai gap kho khan ve tai chinh de giam met phan hoac town be nghia vu tai chinh trong cac twang hop can cham soc y to khan cap hoac khi c6 nhu cau cham soc y to tai BIDMC.

HO try town bii: Cac benh nhan hoac nguai bao lanh cua ho c6 mire thu nhap hang nam duai 200% so voi mire cua FPL se dugc giam 100% nghia vu tai chinh khi sir dung cac dich vu y to do BIDMC cung cap.

Ngtroi ban lanh: Nguai (khong phai benh nhan) c6 nghia vu tra tien cho cac h6a don dm benh nhan.

TOng chi phi: Tong chi phi sir dung cho cac dich vu cham soc benh nhan trugc khi op dung cac khoan khau

Vo gia theo dinh nghia cua chinh quyen lien bang, dugc cong bo trong Dang 14 lien bang bai HUD: Met ca nhan hay gia dinh thieu met ch6 a on dinh, thIrmg xuyen va du vao ban dem, c6 nghia la ca nhan hay gia dinh do cu tru ban dem tai nhung noi thtrang khOng phai danh cho nguai, hoac nhung nai a tam bg do met ca nhan hoac tap the thiet ke. Khai niem nay cung c6 the bao gem cac ca nhan rai khoi cho a sau 90 hoac it hon 90 ngdy cu tru , cu tru a met nai tam bq hoac nai khong danh cho nguai truck khi chuyen den noi a mai.

Try cap kho khan y t6: Ho trg tai chinh cho nhitng benh nhan du dieu kien — nhCing nguai phai thanh toan hoa don len hon hoac bang 25% so voi tong thu nhap cua ho.

Cham soc y to can thiet: Cac dich vu y to can thiet, vi du nhu cac dich vu cham soc not tru hoac ngoai tru voi muc dich danh gia, chan doan, va/hoac dieu tri chan thuang hoac benh, cling nhu cac dich vu dien hinh dugc dinh nghia boll Medicare hoac bao hiem y to khac tai "muc dugc bao hiem hoac dich vu".

Phi dich vt! Medicare: Bao hiem y to dugc cung cap theo cac phan A va B cua Medicare, chuang muc XVIII dm Dao luat an sinh xa hei (42 USC 1395c-1395w-5).

Ho try mot phAn: Ho trg tai chinh bieu hien bang cach giam gia cac dich vu y to dtrac BIDMC cung cap, cho nhiing benh nhan du dieu kien, hoac nguai bao lanh cua benh nhan, co muc thu nhap hoac nam tir 201% - 400% so voi

Trung tam Y to Beth Israel Deaconess Chinh sach ho trg tai chinh Trang 5

Mirc ngheo kho lien bang.

Ke hoach chi tra: ke hoach chi tra dugc thOa thuan gifra BIDMC hoac ben thir ba dai dien cho BIDMC vas benh nhaningued bao lanh ve cac khoan phi thuc tra. Ke hoach chi tra se xem xet den hoan canh tai chinh cua benh nhan, khoan no vas so tien tra truac.

Dii tieu chuan chy kien: Trong nhung truang hop nhat dinh, cac benh nhan khgng c6 bao hiem c6 the dugc gia dinh hoac dugc coi la hgi dit dieu kien de nhan trg cap tai chinh dua vao hg so dm ho trong cac chuong trinh tham tra kha nang hoac cac nguon thong tin khac, khong do ban than benh nhan cung cap de danh gia nhu au tai chinh cua ca nhan.

Nha cung cap dich vu bao hiem y to ttr nhan: Bat ky to chirc nao ngoai trig cac don vi trong chinh phu cung cap dich vu bao hiem y te, ggm ca cac to chirc phi chinh phu dieu hanh mgt chuong trinh bao hiem y to theo chuong trinh Medicare Advantage.

Thai gian tham dinh: Nhang ngugi hgi du tieu chuan se than dugc trg cap tai chinh trong khoang thed gian sau thang. Nhang benh nhan dugc hg trg tai chinh nay co the chimg minh rang khgng c6 thay dgi ve tinh trang tai chinh vao cugi thang thir sau (6) dm khoang thai gian tren de dugc gia han them sau (6) thang

Giam gia cho benh nhan khOng có bao hiem: Nhang benh nhan khgng co bao hiem dm ben thir ba se dugc huamg chinh sach giarn gia trong tnramg hop khong c6 bao hiem cho cac dich vu di" tieu chuan dugc cung cap bai BIDMC, dong thgi phan chi phi chua dugc chiet khau tnrac day se dugc hoan tra.

Benh nhan khong co bao hiem: Mgt benh nhan !thong c6 bao hiem do ben thir ba cung cap bai mgt cong ty bao hiem thucmg mai ben thir ba, mgt ERISA, mgt Chuang trinh cham soc sirc khoe lien bang (Om khong gio7 han Medicare, Medicaid, SCHIP, vas CHAMPUS), Bao hiem lao dgng, hoac cac WO' trg khac tir ben thir ba giup trang trai chi phi cham soc stk khoe cua benh nhan.

Benh nhan khong du bao hiem: Bat Ic.r ca nhan nao c6 bao hiem to nhan hay bao hiem nha nuoc, nhung se la kh6 khan neu ho phai to tra town bg chi phi cham soc sire khoe khi sir dung cac dich vu cua BIDMC.

Chasm soc khan cap: Nhang dich vu y to can thiet phai sir dung sau qua trinh khori phat dgt nggt cua mgt tinh trang y khoa, du la tinh trang thuc the hay tinh than, bieu ,hien bang cac trieu chimg cap tinh mire dg nghiem trong (ggm ca dau cap tinh) ma mgt nguai than trong binh thueyng tin rang neu khong co can thiep y to trong yang 24 gig se gay nguy hiem cho benh than, suy giam chirc nang co the, rgi lop chirc nang cua mgt co quan hoac tan bg co the. Dich

Trung tam Y te` Beth Israel Deaconess Chfnh sach ho trg tai chinh Trang 6

Cac dich vu du dieu kien nh4n ho tro' tai chinh

Cac dich vv . killing du dieu kien nh4n 1145 trot tai chinh

Dinh gia nhu , cau sure khoe

ctia Ong dtong

vu cham soc sire khoe khan cap dugc cung cap trong nhang dieu kien khong de doa tinh mang va khong gay nguy hai cho sire khoe cua ca nhan. Dich vu chain soc sire khoe khan cap khong bao gom chain soc co. ban va chain soc to chon.

Cac dich vu du dieu kien theo chinh sach ho tro. tai chinh cua BIDMC phai phi' hop ve mat lam sang va nhang lieu chuan thuc hanh y khoa dugc chap nhan. Bao gom nhimg dich vu sau:

1. Dich vu y to cap dru, cung nhu cac dich vu dugc cung cap trong tinh trong khong khan cap \Teri muc dich on dinh tinh trong cua benh nhan.

2. Cac dich vu khong to chon dugc cung cap de doi pho voi nguy co de doa tinh mang trong tmamg hop khong cap cum

3. Cac dich vu y t6 can thiet, chang han nhu dich vu chain soc sue khoe not tru hoac ngoai tru voi muc dich danh gia, chan doan, va/hoac diet' tri chan thtrcmg hoac benh, cling nhu cac dich vu dugc dinh nghla bai Medicare hoac bao hiem y to khac tai "muc dugc bao hiem hoac dich

4. Cac nha cung cap dich vu thuc BIDMC va nhang ngtrai theo chinh sach nay. Xem Phu luc Bo'n (4) de xem danh sach day du cac nha cung cap theo chinh sach nay.

Cac dich vu khong du di'eu kien nhan ho tro tai chinh 9 6m: 1. Thu tuc y to chon chit khong phai la sir can thiet ve mat y ta, ding nhu

nhimg ,dich vu khong dien hinh sduocliets ke boi Medicare hoac cac bao him y to khac ma khong can thiet ye mat y khoa.

2. Cac dich vu nhfing nha cung cap khong ,thuOc BIDMC (vi du, bac si to hoac khong thuc BIDMC, di chuyen bang xe dru thuong, v.v...). Benh nhan dirge khuyen khich lien N true tiep vei cac nha cung cap de xem ho có cung cap dich vu, ho try va sap xep‘thanh toan hay khong. Xem Phu luc Beni (4) de xem danh sach day du cac nha cung cap theo chinh sach nay..

3. Cac khoan khau trir va &Ong bao hiem lien quan den dich vu y to can thiet cung cap cho benh nhan ngodi mang dugc xac dinh boi ding ty bac, hiem cua ho.

MOt danh gia nhu cau sire khoe cung dling dugc thuc hien va dugc sir chap thuan,ctia HOi &Ong quan tri vao ngay 18/9/2013 de xac dinh va danh gia nhu cau ve sire khoe trong khu vuc ma BIDMC cung cap dich vu. Phan loci sau day ve cac van de lien quan den sire khoe va dan so , cac van de nay da &roc xac dinh la van de tru tien — k6t qua dm danh gia neu ten.

Cac van de sfic khoe lien quan va Quan the dich 1. Kiem sok va phong ngira benh tat, Om:

Trung tam Y to Beth Israel Deaconess Chinh sach hO tra tai chit -1h Trang 7

— Dai thao duang, benh tim, ung thu va hen suy8n — Gido duc sirc khoe, theo doi va kiem soat benh Quan the dich: — Nhom có thu nhap thAp — Chung tee/Dan tee thieu se — Nguai dan Boston, dac biet la a Allston/Brighton, North Dorchester,

Roxbury, Fenway/Kenmore; thi tran Outer Cape, Harwich, Wellfleet va Provincetown, cling nhu Quincy.

2. Danh gia sue kh6e, gem: — Cham soc y to co. ban — Cham soc y to dac Net — Cham sOc sire khoe hanh vi — Cham sOc nha khoa Quan the dich: — Nhom co thu nhap thAp — Chung tec/Dan tee thieu se — CO, khong co hoac thieu bao hiem Medicaid

3. Song kh6e, Tap the duc va Dinh &Ong, gom: — Tap the duc day du — Dinh &fang — Thuc pham an town — Hang xom tot Quan the dich: — Tat ca

4. Sire khoe hanh vi, gam: — Tram cam, lo au, stress — Lam dung Ma chat — Tiep can cham soc sue khoe — Giet nguai/Bao luc gia dinh

Quan the dich: — Cu dan Roxbury va Dorchester — Nguari 16n nghien opioid

Can chi y rang BIDMC cling se dau to va ho try mat so it cac linh vuc khac narn ngoai nhang linh vuc uu tien neu ten. Nhang no luc vi cong dong cua BIDMC se luan duot chit trong a nhang nai can thiet va nhang nai có co hei tac dong.

Ban sao bao cao day du co the xem tai trang web dm cluing toi: http://www.bidmc.org/—/media/Files/Centers%20and%20Departments/Comm unity%20Initiatives/Final CHNAReport92313 .pdf

Chuang trinh V6ri nhang ca nhan khong có hoac thieu bao hiem, benh vien se lien hanh lam

Trung tam Y te' Beth Israel Deaconess Chfnh sach tio tra tai chinh Trang 8

hO try. cong dOng

His; try. tai chinh b'eth 00 thong qua Health Safety Net

viec vii benh nhan de ho trg ho clang kSr nhan ho trg tix cong dOng va/hoac cac chuang trinh he trg tai chinh cua benh vien, ho trg ho thanh town met phan hoac toan be vien phi. Nham gidp cac ca nhan khong c6 hoac thieu bao hiem tim kiem the ltra chon thich hop hien c6, benh vien se cung cap cho tat ca cac ca nhan nhung thong tin chung nhat ve cac chtrcmg trinh ho trg hien hanh tai cong (long ding nhu cac chucmg trinh ho trot ye tai chinh ngay tir khi dang trong hoa dan chuyen den benh nhan hoac ngtroi bao lanh, khi ngtrai cung cap dugc thong bao hoac thong qua nhung ra soat dac biet ye nhimg thay doi ve tinh trang du dieu kien cua benh nhan doi vii bao hiem cong cong hoac to nhan.

Cac benh nhan c6 the c6 du dieu kien giam hoac mien phi khi dung cac dich vu cham soc sire khOe thong qua nhieu chuang trinh ho trg tir cong Tong ding nhu chuang trinh ho trg tai chinh cua benh vien (gem khong giii han MassHealth, chtrang trinh ho trg chi tra dieu hanh bii Health Connector, Children's Medical Security Program — Chuang trinh An ninh y to cho tre em, Health Safety Net, and Medical Hardship). Nhung chtrang ,trinh nay dg kien h8 trg cho cac benh nhan c6 thu nhap thap tinh den kha nang ding dung gap tra chi phi dm ho. Doi vii nhung benh nhan khong c6 hoac thieu bao hiem, neu dirge yeu cau, benh vien se giup ho clang k5T cac chuong trinh htitrg tir cong clung hoac chucmg trinh Ito trg tai chinh dia benh vien, giup ho chi tra met phan hoac town be chi phi ma ho chtra tra cho benh vien.

Benh vien luon san sang hti trg benh nhan trong viec clang 1(57 cac chuang trinh ho trg cila bang. Gem, MassHealth-chuang trinh ho trg chi tra to chirc bai Health Connector, va Children's Medical Security Plan. Doi voi nhung chucmg trinh nay, ngtrai clang l(ST se xac nhan viec clang 14 thong qua trang web (nam i chinh giaa trang web cUa Health Connector), viet don clang 14 hoac clang kST qua dien thoai vii dai dien dich vu khach hang tai MassHealth hoac Connector. Cac ca nhan di the yeu cau trg giup co van tai chinh benh vien ding vii viec xac nhan clang kS7 qua trang web hoac viet giay clang kST.

Qua viec tham gia vao Massachusetts Health Safety Net, benh vien cung cap cac he trg tai chinh cho nhung ngtrai co thu nhap thap, khong c6 bao hiem hoac khong du bao hiem la cu dan Massachusetts va dap irng cac tieu chuan ve thu nhap. Health Safety Net clugc thanh lap de phan be chi phi hO trg met each cong bang hon cho nhitng ngtrai thu nhap thap kitting c6 hoac thieu bao hiem thong qua viec mien phi hoac giam chi phi tai the benh vien cap a Massachusetts. Tap hop cac cham soc khong cong dm Health Safety Net clugc thgc hien thong qua viec clanh gia tren mei benh vien de trang trai chi phi cham soc sire khOe cho cac benh nhan khong co hoac khong du bao hiem c6 mire thu nhap dual 400% so vii Dinh mire ngheo doi lien bang. Chinh sach ctia benh vien cho phdp tat ca cac benh nhan, nhimg ngueri nhan trg cap tai chinh theo chinh sach ho trg tai chinh benh vien gem ca cac dich vu cita

Trung tam Y to Beth Israel Deaconess Chit -1h sach 116 tra tai chinh Trang 9

Health Safety Net nhu la mot phan cua viec cham sac mien phi cho cac benh nhan thu nhap thap.

Qua viec tham gia vao Health Safety Net, nhi-mg benh nhan c6 thu nhap thap nhan cac dich vu tai benh vien c6 the du dieu kien dugc ho trq tai chinh, co the la mien phi toan b0 hoac mot phan cho cac dich vu du dieu kien tai Health Safety Net, xac dinh a 101 CMR 613:00.

(a) Health Safety Net (Mang heal an town sire khae) — Can ban Cac benh nhan la cu dan Massachusetts dal xac nhan thu nhap cua MassHealth MAGI Household hoac thu nhap Medical Hardship Family, nhu m6 to a 101 CMR 613.04(1), M. 0-300% cna Dinh mix ngheo doi lien bang (FPL) c6 the dugc xac dinh du dieu kien tham gia Health Safety Net Eligible Services.

Thai gian du dieu kien va loai dich vu cho Health Safety Net - Primary dirge giai han cho cac benh nhan du dieu kien clang 14/ Premium Assistance Payment Program (Chuang trinh h8 trg chi tra) to chirc boi Health Connector nhu mo to 6. 101 CMR 613.04(5)(a) va (b). Cac benh nhan phu thutic Student Health Program (Chuang trinh sire khoe hoc duong) yeu eau M.G.L. c. 15A, § 18 khong du dieu kien tham gia Health Safety Net — Primary.

(b) Health Safety Net — Secondary (Ate cap) Cac benh nhan la cu dan Massachusetts c6 bao hiem y to co ban va Thu nhap caah0 gia dinh hoac Medical Hardship Family Countable Income (Thu nhap tinh dirge cua gia dinh kh6 khan ye y te), nhu mo to a 101 CMR 613.04(1), tir 0-300% FPL co the du dieu kien tham gia Health Safety Net Eligible Services. Thai gian du dieu kien va loai dich vu cho Health Safety Net - Secondary dang 14 Premium Assistance Payment Program to chirc bed Health Connector nhu mo to 6. 101 CMR 613.04(5)(a) va (b). Cac benh nhan phu thuck Student Health Program (Chuang trinh sire khOe hoc throng) yeu eau M.G.L. c. 15A, § 18 khong du dieu kien tham gia Health Safety Net — Primary.

(c) Health Safety Net - Partial Deductibles (Kheiu trie tieng ph dn) Cac benh nhan du tieu chuan cho Health Safety Net Primary or Health Safety Net - Secondary voi thu nhap MassHealth MAGI Household hoac Medical Hardship Family Countable Income tir 150.1% - 300% oh FPL c6 the dugc khau trir hang nam neu tat ca cac thanh vien cila Premium Billing Family Group (PBFG) c6 thu nhap tren 150.1% so voi FPL. Nhom nay dugc xac dinh tai 130 CMR 501.0001.

Neu c6 thanh vien cua PBFG co thu nhap duai 150.1% FPL thi se khong CO khau trir cho bat cu thanh vier' nao cua PBFG. Khan trir hang nam tuemg &rang hoac lon han:

Trung tam Y te" Beth Israel Deaconess Chfnh sach h6 trcr tai chfnh Trang 10

1. Chi phi thAp nhAt cua Chircmg trinh h6 trg chi tra to chirc bai Health Connector premium, diet' chinh theo kich think cua PBFG tuung img voi cac tieu chuan ye thu nh6p cua MassHealth FPL, tinh den dau nam throng lich, hoac la 2. 40% khac biet giita mdc thu nh4p thAp nhAt theo MassHealth MAGI Household hoac Medical Hardship Family Countable Income, nhu mo to a 101 CMR 613.04(1), trong Premium Billing Family Group (PBFG) lid 200% FPL.

(d) Health Safety Net - Medical Hardship , Cu dan Massachusetts bat kST có the dieu kien tham gia Medical Hardship thong qua Health Safety Net neu chi phi y to \area qua mire thu nh4p cua ho, khien ho khong có kha Wang chi tra. De dap frng cac dieu kien dm Medical Hardship, chi phi y to cho phep cua nguoi dang ky phai vugt qua mot tST le nhat dinh so v6i thu nhap tinh dugc cua ho, dugc xac dinh tai muc 101 CMR 613 nhu sau:

Wm thu nNip TS, 1"' thu nhap tinh dugc 0 - 205% FPL 10% 205.1 - 305% FPL 15% 305.1 - 405% 20% 405.1 - 605% FPL 30% >605.1% FPL 40%

Mire dong gOp cua ngu6i dang ky dugc tinh town theo mot tST le nhAt dinh theo thu nhap tinh dugc, tai mvc 101 CMR 613.05(1)(b) dua teen Medical Hardship Family's FPL nh4n voi thu n1-4 thuc to tinh dugc, hoa dun khong du dieu kien chi tra Health Safety Net, tir do ngu6i n6p dun se giu nguyen nghia vv. Cac yeu cau khac doi voi Medical Hardship dugc xac dinh tai mvc 101 CMR 613.05.

D6i voi the benh than dti dieu kien tham gia Medical Hardship, benh vien có the yeu cau mot khoan dat coc. S6 lien dat coc dugc giai han a mirc 20% dm mire dong g6p Medical Hardship len den 1000 USD. Cac khoan con lai se phv thuc cac dieu kien thanh town dugc xac dinh a mvc 101 CMR 613.08(1)(g).

V6i Medical Hardship, benh vien se lam viec v6i benh nhan de )(de dinh lieu mot chuang trinh nhu Medical Hardship có thich hgp va xac nNri dun Medical Hardship den Health Safety Net. NgIfia vu cua benh than la phai cung cap tat ca cac thong tin ma benh vien yeu cau trong khoang thoi gian dinh tru6c de chac chan rang benh vien co the xac nhan mot la don hoan chinh. Neu benh nhan có the cung cap tat ca cac thong tin thing hen, benh vien se c6 gang xac nhan va hoan tat dang 14 do trong yang nam (5) ngay lam viec. Neu Neu don clang ky kh6ng dugc )(de then trong vong nam ngay lam viec, hoat dOng tiep nh4ri có the 'thong dugc thuc hien doi vori cac benh nhan có hoa don du dieu kien tham gia Medical Hardship.

Trung tam Y fe Beth Israel Deaconess Chfnh sach ho tra tai chinh Trang 11

Vai tro cua et) A van ho trg tai

chinh

Benh vien se h8 trg nhimg ca nhan khong c6 hoac thieu bao hiem dang ,14 nhan cac trg cap sire khoe qua cac chirung trinh ho trg cong dong (Om nhung 'thong giai han MassHealth, chuong trinh ho trg thanh town tien hanh boi Health Connector va Children's Medical Security Program), lam viec voi nhfing ca nhan do de giup ho clang ky mot each thich Nip nhat. Benh vien clang se ho trg cac benh nhan c6 mong muon dang 14 nhan ho trg tai chinh tir benh vien, g6m cac ho trg qua Health Safety Net va Medical Hardship.

Benh vien se: a) cung cap tat ca thong tin ve cac s chirung trinh, g8m MassHealth,

chirung trinh 118 trg chi tra dieu hanh bai Health Connector, Children's Medical Security Program, Health Safety Net, va Medical Hardship;

b) giup cac ca nhan hoan thanh viec dang ky nhan trg cap moi hoac gifip ho gia han clang 14 nhan trg cap di;

c) lam viec vai ca nhan d6 de thu thap tat ca cac tai lieu yeu cau; d) xac nhan Tang ky hoac gia han (ding vai tat ca tai lieu chrot yeu

cau); e) tuang tac vai cac chircmg trinh ve tinh trang cua cac clang 14 hoac

gia han nay khi c6 the va khi dirge phdp theo gioi han cua cac he thong hien tai;

trg nhan cac clang ky trg cap va thu twang tir cac chirung trinh bao hiem; va

g) cap va ho trg dang ky

Benh vien se to van cho benh nhan ve cac nghia vu cua minh de cung cap cho benh vien va cac ca ,quan nha ntrov, ding voi thong tin ye chinh xac, kip thoi ye ho ten, dia chi, so dienthoai, ngay thang nam sinh, ma SSN (neu c6), ltra chon bao hiem hien tai (gam nha, xe hoac cac bao hiem trach nhiem khac) c6 the trang trai chi phi cham soc sire khoe, va cac nguon luc tai chinh khac, thong tin cong clan va cu trio. Thong tin nay se dirge xac nhan tai bang nhix la mot khau cila qua trinh dang ky than ho trg cong Tong de xac dinh mire chi tra cho cac dich vu y to cap cho ca nhan.

Neu ca nhan hoac nguoi , bao lanh khong cung cap dirge cac thong tin can , thiet, benh vien c6 the co gang tim kiem cac thong tin tir cac nguon khac (neu benh nhan yeu cau). Nhimg no luc nay se bao g8m tien hanh lam viec voi cac ca nhan khi dirge yeu cau, xac dinh xem c6 nen gin cac h6a don dich vu den ho de ho trg khau trir mot lan. Dieu nay xay ra khi mot ca nhan sap xep dich vu cua ho, trong suot thai gian truck clang 14, trong khi nhap vien, khi xuat vien hoac trong mot thai gian nao do thich hop sau khi xuat vien. Cac thong tin ma benh vien co dirge se dirge luu trt theo cac luat ye quyen rieng tir va luat an ninh.

Benh vien cling se thong bao cho benh nhan trong su'Ot qua trinh dang ky ve

Trung tam Y te. Beth Israel Deaconess Chinh sach ho tra tai chinh Trang 12

Nghia vu cua benh nhan

trach nhiOm phai bao cao cho bOnh vien va cac ca quan nha ntrac cung cap ho) . trg cho cac dich vu cham soc sirc khOe bat ad ben Mir ba lien quan ca ,the nhan trach nhiOin chi tra, gom nha cira, xe co, hoac chinh sach bao hietn,phaply khac. Neu bOnh nhan da xac nhan yeu cau dm ben thu ba va yeti cau doi den bu tir ben thin ba, bOnh vien se thong bao cho bOnh nhan ve viOc phai bao cao cho cac nha cung cap va cac chtrang trinh cua nha ntrac trong yang 10 ngay ke tir khi xac nhan. BOnh nhan cung se dugc thong bao rang ho se phai tra lai co quan nha nu& so tien ho trg ch5m soc sirc khOe neu co thoa thuan the quyen, hoac uy quyen cho co quan nha mroc de ho thu lai so tien tucmg timg.

Khi ca than lien hO yeti bOnh viOn, , bOnh vien ca gang xac nhan xem ca nhan d6 co dap img cac yeu cau de nhan ho trg tir cac chuong trinh cua cung d'Ong hoac bOnh vien hay khong. Ca nhan dang ky tham gia chuong trinh 11'6 trg tir cong (long co the du dieu kin nhan dugc nhiing lgi ich nhat dinh. Cac ca nhan ding c6 the du dieu kien nhan cac ho trg bO sung dua vao chtrong trinh ho trg tai chinh bOnh vien, cac ve thu nhap ca nhan va chi phi y to cho phep.

'fru& khi sir dung bat kY mot dich vu charn ,soc sirc khOe nao (trir twang hop benh nhan trong tinh trang cap dm hoac can chain soc cap), bOnh than nen dugc cung cap mot each chinh xac va kip thoi cac thong tin ve tinh trang bao hiem, thong tin ca nhan, cac thay doi trong thu nhap, chinh sach bao hiOm nhom (neu c6), va, neu Hen, thong tin ye mix khautrir hoac citing chi tra do cong ty bao hiem hoac chuong trinh tai chinh yeu cau. Thong tin chi tiet cho moi muc bao gom , nhung khong han chO:

• Ho ten, dia chi, so din thoai, ngay thang nam sinh, ma SSN (n6u co), cac lua chon bao hiem y hiOn tai, thong tin quoc tich va trtii, cac nguon luc tai chinh ma bOnh nhan c6 the dung de chi tra cho cac hoa don;

• N6u co th& neu ten day MI ciia nguai bao lath cho bOnh than, dia chi dm ho, so din thoai, ngay sinh, ma SSN (neu c6), cac lua chon bao hiem y to hiOn tai, va cac nguon luc tai chinh ma ho c6 the dung de chi tra cho cac hoa don dm bOnh nhan; va

• Cac nguOn luc khac c6 thO' dung a chi tra cac h6a don, Om cac chuong trinh bao hiem khac, xe co hoac cac hop &Mg bao hiem nha neu viOc dieu tri la do tai nan, cac chtrong trinh boi time:mg lao clOng, hgp Tong bao hiem hoc &rang, va bat ctir nguon thu nhap nao khac cua gia dinh nhu tai san thira Ice, qua tang hoac cac tai san Ay thac khac.

13Onh than c6 nghia vu theo doi cac khoan vien phi chua tra, Om -tit ca cac khoan dong chi tra, &hiem ,

mg baokhau trir, va lien hO \Ted bOnh vien neu ho

can h6 trg chi tra mot phan hoac town bO vien phi. BOnh nhan ding dugc yeu cau thong bao ve bao hiem y to hi"On tai cua ho (n6u ho co) hoac ca quan da xac dinh ve tinh trang du dieu kin cua ho khi tham gia mot chuong trinh

Trung tam Y te` Beth Israel Deaconess Chfnh sach 116 tro. tai chit -1h Trang 13

Cac tieu chu"Un ho tro' tai chinh berth vien

Ong d6ng khi thu nhap cua gia dinh hoac tinh trang bao hi6m co thay Benh vien ding c6 the he trg benh nhan cap nhat tinh trang du dieu kien cua ho khi tham gia met chucmg trinh cong dong khi co bat cir thay doi nao trong thu nhap cua gia dinh hoac tang thai bao hiem neu benh nhan thong bac, cho benh vien ve cac thay doi nay.

Cae berth nhan ding dirge yeu cau cho , biet cac berth vien cac chuang trinh ma tir do ho nhan dirge sir giup (chang han, MassHealth, Connector, Health Safety Net, hoac Medical Hardship), cac th8ng tin lien quan den thu nhap etia gia dinh, hoac ho co dugc nhan bed thirang bao hiem de tra vien phi hay khong. Neu c6 ben thir ba (vi du, nhung khong giai han, bao hiem nha hoac xe) chiu tacit nhiem chi tra chi phi cham soc do tai nan hoac the tai bien khac, benh nhan se lam viec vbi benh vien hoac met chuong trinh thich hop (gem, nhung khong giai han, MassHealth, Connector, hoac Health Safety Net) de uy quyen thu hoi so ti'en da tra hoac chua tra cho dich vu do.

Ho trg tai chinh se" duce ma rang cho cac benh nhan khong c6 hoac thiau bao hiem, mien la la dap Ung dirge cac tieu chi xac dinh ben duai. NhUng tieu chi nay dam bao cho chinh sach ho trg tai chinh dugc dp dung met each thong nhat trong the co. sec thuee BIDMC. BIDMC gicr quyen sira doi, be sung hoac thay doi chinh sach nay neu can hoac xet thay phii hop.

BIDMC se no luc thu thap cac thong tin v‘ tinh trang bao hiem dia benh nhan va the thong tin khde de xac nhan bao hiem trong nhimg trtremg hop cap dru, chain soc sue khOe Wei tru hoac ngoai tit tai cac benh vien. Tat ca cac thong tin se dugc thu thap truac khi tiep nhan cac ca kh6ng cap dru hoac khong khan cap (vi du, quy trinh tu chon dugc dinh nghia trong phan Chinh sach thanh toan va truy thu). Benh vien hoan viec thu thap thong tin trong tnrang hop co ca thuec mire cap dru EMTALA hoac dich vu cham soc sire khoe cap, neu quy trinh bi hoan hoac gian doan do the xet nghiem y khoa nh'arn on dinh met tinh trang cap dru cua benh nhan.

Benh vien luon no luc va can trong xem xet lieu c6 ben bao hiem thir ba hoac nguon Luc nao khac co the gifip trang trai chi phi cho the dich vu y to hay khong, nhUng hoat Ong nay gem, nhung khong giai han, xac dinh xem c6 chinh sach nao gifip 116 trg chi phi hay khong: (1) xe ce hay chinh sach phap 1ST nha a, (2) chinh sach bao ve tai nan not chung hoac thucmg tat ca nhan (3), chtrang trinh boi thuemg lao deng, va (4) cac chinh sach bao hiem hoc dixemg (student insurance policies), va met so khac ntta. Neu benh vien co the xac dinh met ben tit* ba chiu trach nhiem hoac da !than thanh town tir met ben thin ba hoac tir met ngu8n nao khac (g8m ca bao hiem tir nhan hoac chuang trinh cong dong khac), benh vien se bao cao viec thanh town nay den chucng trinh ap dung va dirng chtrong trinh do, neu yeu cau xir .15r, dei voi bat cu yeu cau nao c6 the da dugc chitra bed ben thir ba hay nguen khac. cac chuang trinh h6 trg cong dong cua nha nuac ma thuc to da chi tra cho cac dich vu,

Trung tam Y to Beth Israel Deaconess Chfnh sach ho tra tai chfnh Trang 14

benh vien khong yeu cau benh nhan fly quyL cho ben thir ba. Trong nhang tnremg hop nhu vay, benh nhan can km ST rang cac chuang trinh cua nha nuac co the co tim su uy thac chi tra cho cac chi phi ma benh nhan sir dung.

Nguan chi tra (bao hiem lao deng, Medicaid, Indigent Funds — Quy danh cho nguoi ngheo, Victims of Violent Crime — Nan nhan cua tei pham bao luc, v.v...) phai clugc xem xet va danh gia tnxac , khi benh nhan dugc can nhac WO" trg tai chinh. Neu xet thay benh nhan c6 the dit dieu dien nhan met ho trg khac, BIDMC se gioi thieu benh nhan den mot co . so do de hoan thanh cac thu tuc clang 14. Nhimg nguoi clang 14 nhan h6 trg can phai dung het lua chon chi tra khac, xem nhu la met dieu kien de hoc nhan dugc h6: trg tai chinh

Nhang nguoi clang 14 nhan hi; trg tai chinh can c6 nhiem vu clang 14 cac chuang trinh cong dong va theo duoi cac goi bao hiem to nhan. Benh nhan/nguoi bao lanh lua chon khong hop tac trong qua trinh clang 14 cac chucmg trinh ma BIDMC nhan thay c6 cac nguon chi tra kha di c6 the bi tir choi trg giup tai chinh. Nhimg nguoi clang 14 luon dugc ky vong se dong g6p dugc phan nao do chi phi cham s6c sire khoe, dua vao kha nang chi tra cua ho dugc phac thao trong chinh sach nay. BIDMC se kiem tra Massachusetts Eligibility Verification System ,(EVS — He thong xac nhan tinh dudieu kien dm Massachusetts) de dam bao rang benh nhan khOng phai la benh nhan c6 thu nhap thap va chua xac nhan don clang 14 vao MassHealth, chucmg trinh ho trg chi tra dieu hanh bed Health Connector, Children's Medical Security Program, Health Safety Net, hoac Medical Hardship, throe khi xac nhan yeu cau den van phong dm Health Safety Net de trang trai ng xau.

N'6u khong c6 chi tra d4c biet nao cho cac dich vu da dugc sir dung, benh vien se lam viec v6i benh nhan de xac dinh lieu co met lua chon chucmg trinh khac hay khong, chang han nhu Medical Hardship thong qua Health Safety Net, san c6 nher vao cac dieu le cua Health Safety Net. Nghia vu cua benh nhan la phai cung cap day du cac thOng tin dugc benh vien yeu cau trong khoang thed gian xac dinh de dam bao rang benh vien c6 the xac nhan met clang 14T hoan chinh. Benh vien se no luc de ,xac nhan viec clang trong yang nam (5) ngay lam viec sau khi nhan dugc day du thong tin tir benh nhan. Neu viec clang 14 nay khong dugc xac nhan trong yang nam ngay lam viec ke tir khi nhan dugc cac thong tin can thiet trong khoang thoi gian xac dinh theo yeu cau cua benh vien, cac hoat deng thu thap thong tin se khong dugc tien hanh teen benh nhan dit cac hoa clan c6 du dieu kien tham gia Medical Hardship.

Benh nhan/Nguoi bao lanh có th6 du dieu kien tham gia Medicaid hoac cac bao hiem y to khac phai clang 14 hang muc bao hiem cila Medicaid hoac trinh cac chimg cir cho thay ho da clang 14 Medicaid hoac cac loaf bao hiem y to khac qua Federal Health Insurance Marketplace (Thi truOng Bao hiem Y to lien bang) trong yang sau (6) thong tir khi clang 14 nhan trg cap tai chinh tir BIDMC. Benh nhaniNgued bao lanh phai hop tac trong qua trinh clang ky

Trung tam Y te Beth Israel Deaconess Chfnh sach 118 tra tai chfnh Trang 15

dtrgc xac dinh trong chinh sach nay de dam bao cac dieu kien nhan 116 tra tai chinh.

Cac tieu chuan se &roc xem xet beri BIDMC khi danh gia mot benh nhan c6 dit dieu kien nhan tra cap hay khong, gom: • Thu nhap cita ho gia dinh • Tai san • Nglira vu y t6

Tat ca moi ngtriyi deu c6 quyen tham gia chtrcmg trinh 118 tra tai chinh cita BIDMC mien la ho dit cac dieu kien yeu cau theo muc tren day cila chinh sach nay, bat ke vi tri dia 1Y hay tinh trong cu trit. Cac hO tra tai chinh &rot cap cho benh nhaningtrin bao lanh dga tren nhu cau tai chinh va phit hop yeti luat tieu bang va lien bang.

Ho tra tai chinh se dugc cap cho nhang benh nhan khong du bao hiem thoa man cac tieu chi xac dinh, cac ho tra nhu vay cling tuan theo cac thoa thuan da ky trong cac hop &Ong bao hiem. Nhin chung, cac ho tra tai chinh khong san c6 cho cac benh nhan dong chi tra hoac so du trong trugng hop benh nhan kh6ng tuan thit cac yeu cau bao hiem.

Nhung benh nhan c6 Health Savings Account (HSA-Tai khoan tiet kiem y te), Health Reimbursement Account (HRA-Tai khoan boi hoan y te), hoac Flexible Spending Account (FSA-Tai khoan chi tieu linh hoat) ky ,vong se , drat sir dung truck khi nhan cac 116 tra tai chinh. BIDMC co quyen thay doi cac mo td viec giam chi phi trong chinh sach nay neu nhan thay cac dieu khoan nay vi pham cac nghia vu hop dong va phap 1ST cua BIDMC.

Giam gia ho trg Dtra teen viec danh gia thu nhap, tai san va nghia vu y to cua ngugi dang ky, tai chinh benh nhan se nhan dtrgc mot trong cac ho tra sau day:

Giam gia ttiv thin: Nhang berth nhan khong &roc chi tra bai ben thin ba va khong di" dieu kien nhan cac chung trinh Ho tra cong (tong hoac Ho tra tai chinh se dtrgc giam gia 30%. Viec thanh town phai dtrgc thgc hien ngay truck khi sir dung cac dich vu. Khoan giam gia nay cling c6 the dugc ap dung cho cac dich vu phi y te.

Trung tam Y te' Beth Israel Deaconess Chinh sach he) tra tai chinh Trang 16

Viec nay cung khong ngan can benh nhan/nguai bao lanh dang ky va van du to cach tham gia cac chuang trinh ho tra tai chinh khac. Benh nhcin có hero hiem tinh nguyen clang kY to tra se khong cau (lieu kien nhan ho tro tai chinh cho cac khoan no tren tai khoan clang kfi ty. tra.

HO try. town BIDMC se ho trg 100% chi phi cham soc theo chinh sach nay cho nhitng nguai ma gia dinh c6 thu nhap bang hoac duoi 200% dm Dinh muc ngheo doi lien bang.

HO try. mot phAn: Benh nhan dugc giam 50% chi phi cho cac dich vu tai BIDMC theo chinh sach ho trg tai chinh cho cac benh nhaninguei bao lath khong có bao hiem hoac khong du bao hiem, voi diet' kien mirc thu nhap cua gia dinh tir 201% den It hon hoac bang400% so vOi FPL.

Medical Hardship: Nhitng benh nhan tieu chuan dugc giam gia 65%, voi khoan ng y to hon hoac bang 25% so vOi tong thu nhap cua ho.

Chinh sach ho try tai chinh

Thong tin ve chinh sach ho trg tai chinh cua BIDMC, ban tom lugc Ara dang 14116 trg tai chinh hien cla CO va hoan toan mien phi tren tat ca cac web lien ket, coo cac benh vien va phong kham va se &lac dich ra cac thir tieng dugc sir dung boi it !that 1,000 hay 5% cu dan trong yang dich vv.

Them vao dO, chinh sach chi tra va ho trg tai chinh cua BIDMC luon xuat hien teen cac bao cao ye benh nhan hang thang va thu yeu cau chi tra. Thong tin ve chinh sach ho trg tai chinh Won san co, vao bat cir luc nao khi dugc yeu cau:

1. Beth nhan/Nguai bao lanh có the clang 14 nhan ho trg tai chinh vao bat cir It c nao, có the den hai tram bon muoi (240) ngay ke tir sau khi co h6a don sau khi xuat vien.

2. De xem xet ho trg tai chinh, benh nhan/nguoi bao lanh dugc yeu cau phai hop tac va cung cap cac thong tin ca nhan, tai chinh va cac tai lieu khac co lien quan de danh gia nhu cau tai chinh. Don xin ho trg tai chinh co the tim bang mot trong cac cach sau:

a. Teen trang web cira BIDMC http ://www.bidmc.org/Patient-and-Vi sitor-Information. aspx

b. Tai Financial Counseling Unit (Don vi to van tai chinh) 330 Brookline Ave East Campus/Toa nha Rabb Phong 111 Boston, MA 02215 (617) 667-5661

c. Goi den s6 dien thoai tren de yeu cau giri email mot ban sao d. Goi den so dien thoai tren de yeu cau mot ban Ecopy

3. Benh nhan/Nguiri bao lanh can cung cap so lieu th6ng Ice cac quy tai

Trung tam Y te Beth Israel Deaconess Chinh sach 116 tro. tai chinh Trang 17

chinh ma ho có the san sang six dung. Thu nhap cua ho gia dinh có the dugc xac nhan th8ng qua met hoac tat ca cac cach sau day:

a. W2s hien tai b. Ban khai thue thu nhap ca nhan tieu bang hoac lien bang c. Ben (4) cuen Luang gan nhat d. B8n (4) bac, cao boa don hoac khoan tiet kiem gar"' nhAt e. Tai khoan tiet kiem y to f. Cac khoan b8i hoan y to g. Tai khoan chi tieu linh hoat

4. Truac khi danh gia xem CO du diet' kien de nhan trg cap tai chinh hay khong, benh nhaninguiri bao lanh phai dua ra bang chirng cho thay ho da, dang 14 Medicaid hoac cac bao hiem y to khae qua Thi tnrong bao hiem y to lien bang.

a. Cac c8 van sire khoe cda BIDMC se ho trg benh nhaninguei bao lanh khi clang 14 Medicaid va sau do ho trg h9 dang 14 nhan ho tro tai chinh.

b. Neu met ca nhan dang 14 nhan trg cap tai chinh trong khi Thi tnxamg bao hiem y to lien bang ma dm, nhimg ca nhan nay phai tim kiem bao hiem truck khi BIDMC & Affiliate danh gia viec dp dung he trg tai chinh.

5. BIDMC c6 the khong tix choi ho trg tai chinh theo chinh sach nay neu ca nhan c6 sai sot khi cung cap thong tin hoac Oa) , to ma chinh sach nay hoac viec clang k3'r ho trg tai chinh khong m6 to r8 rang.

6. Han chOt BIDMC quyet dinh met ca nhan co du dieu kien nhan ho trg tai chinh hay khong la trong yang ba mired (30) ngay ke tix khi nhan &roc dan clang 14.

7. Giay xac nhan du dieu kien se dugc gan teen tat ca cac tai khoan hien tai cua benh nhan (so du dau14), có hieu luc 6 thang bat dau tir ngay Bang 14, khi chua nhan dirgc thanh town nao tir benh nhan. Thu xac nhan se dirgc giri cho benh nhaningirei bao lanh.

8. Neu benh nhaninguari bao lanh girl met don dang 14r khong day du, se co thong bao cho ho va giai thich ye cac th8ng tin bi thieu. Benh nhaninguei bao lanh se c6 ba mucri (30) ngay chap nhan va cung cap cac thong tin dugc yeu cau. Neu khong hoan thanh don dang 14 thi yeu cau he trg tai chinh se bi tir choi.

9. Viec xac dinh benh nhan c6 du dieu kien nhan ho trg tai chinh hay khong dua teen viec xac !than don °tang ky nhan ht; trg tai chinh se co

an hieu luc trong yang sau (6) thang doi yen tat ca cac dich vu c thiet ma BIDMC & Affiliate cung cap, dua teen ngay giri thu xac than va bao gem tat ca cac khoan phai thu ton dong trong yang sau (6) thang gem ca ng x'Au trir khi viec chi tra cua benh nhan da dugc xac nhan vao tai khodn. Nhang benh nhan dang nhan ho trq tai chinh tir chi nhanh BID se khong can phai tai dang 14 nhan he trg nay tir cac chi nhanh khac nira. Nhiem vu cua benh nhaningtrai bao lanh la phai thong bao cho BIDMC ve cac thay doi tai chinh trong suet thei gian

Trung tam Y te' Beth Israel Deaconess Chfnh sach 1115 tr .a tai cliff -1h Trang 18

sau (6) thang dugc )(de nhan du dieu kien. Neu khong thuc hien c6 the benh nhan se khong con du dieu kien nita.

LS, do tir chai BIDMC có the se tir ched yeu cau h 76 trg tai chinh do nhieu nguyen nhan khac nhau g6m, nhung khong gieri han: • Thu nhap du • CO mirc tai san du • Benh nhan khong hgp tac hoac khong dap tra nhirng co gang hop tae vai

benh nhan/ngueri bao lanh • Khong hoan tat dugc viec (tang kY than ho trg tai chinh bat chap nhung no

luc lam viec voi benh nhaningued bao lath • Dang c6 yeu eau bed thuerng bao hiem hoac phap ly • Khan trir tien bao hiem va/hoac thanh toan tien bao hiem, gom cac khoan tra

cho benh nhaningued bao lanh de trang trai chi phi cho cac dich vu do , BIDMC cung cap, va tai nan bi thucmg va/hoac tai nan c6 lien quan den boi thugng.

Dieu kien BIDMC hieu rang khong phai tat ca benh nhan deu c6 the hoan thanh viec khoan dang ky nhan ho trg tai chinh hoac dap img dugc cac yeu cau ye giay ter. Co

the co trugng hop ma theo dO benh nhaningueri bao lanh van dap img tieu chuan dugc nhan ho trg tai chinh ngay ca khi khong hoan thanh dugc mau dang kY. Cac thong tin khac co the dugc BIDMC sir dung de xac dinh lieu tai khoan dm met benh nhaningugi bao lanh kho thu thap va thong tin nay se dugc dung de xac dinh dieu kien khodn.

Dieu kien khoan c6 the dugc cap cho benh nhan dua vao mire de phi' hop dm ho doi voi cac chuong trinh khac hoac dieu kien song, chang han nhu: • Benh nhan/Ngugi bao lanh tuyen. Trong truemg hop pha san, chi co so du

tai khoan vao ngay pha san dugc thanh town se dugc gach b6. • Benh nhan/Nguei bao lanh qua deri ma khong co bat dOng san trong di chile. • Benh nhan/Ngugi bao lanh dirge xac dinh la vo gia cu. • Tai khoan trer ve veri ca quan thu thap vi khong thu thap dugc voi cac 1)'T do

neu tren va chua nhan dugc khoan thanh town nao. • Benh nhaniNgueri ,bao lanh dap irng cac tieu chuan chuang trinh

Medicaid se dieu kien nhan ho trg tai chinh bat cir nghia vu chia se chi phi nao di doi veri chucmg trinh hoac cac dich vu khong dugc bao hiem.

Tai khoan benh nhan nhan dugc dieu kien khoan se dugc sap xep lai theo chinh sach ho trg tai chinh. Chung se khong dugc giri cho muc dich truy thu hoac cac hoat deng truy thu khac.

Cac dich vu cap Theo cac quy tac cua EMTALA, trugc khi nhan dugc cac cham soc trong ciru y to truemg hop khan cap, khong benh nhan nao bi sang loc xem xet ve ho trg tai

Trung tam Y to Beth Israel Deaconess Chfnh sach fu5 tra tai cliff -1h Trang 19

chinh hoac thong tin thanh town. BIDMC có the yeu cau cac ben cung chia se chi phi voi benh nhan (vi du, &Ong chia se) ding luc voi thoi diem cung cap dich vu. Nhimg yeu cau nay se khong anh huang den viec theo doi, danh gia hoac lien hanh cac tri lieu can thiet de benh nhan qua can nguy cap.

SO tien thong thuirng thanh than

Chinh sach tinh hoa dun va thu phi

Yeu cau then chinh

SO tien thong thtrang thanh town (AGB) &Nye kST vong se do nhang benh nh'aningixei bao lanh dit dieu ,kien nhan ht; tra tai chinh chi tra. voi nhang benh nhaningtroi bao lanh, so tien nay se khOng vtrat qua mot tST le dtrac xac dinh bang phurcmg phap hoi cfru. BIDMC tinh toan AGB bang each chia tong thanh town nhan dtrov tir ke hoach thucmg mai va Medicare cho tong chi phi duge gui den cac doi Wong chi tra tucmg to vao nam tai chinh (FY) lien truo.c. De biet them thong tin, xem Phu luc Nam (5).

Cac hoat dOng có the do BIDMC lien hanh trong truemg hop khong chi tra dirge mo tab mot chinh sach rieng biet, chinh sach tinh hoa don va thu phi. Moi ngubi có the yeu cau ban sao mien phi bang each goi den so (617) 667-5661 hoac truy cap trang web dm BIDMC: http://www.bidmc.org/patient-and-visitor-information.aspx

BIDMC luon tuan theo cac quy tic, dieu le va luat lieu bang va lien bang, will comply with all federal, state and local laws, rules and regulations, va bao cao cac yeu cau co the dp dung cho cac hoat dOng theo chinh sach nay. Chinh , sach nay dOi hOi BIDMC phai theo dai cac ho tra tai chinh da cung cap de dam bao bao cao mot cach chinh xac. Thong tin ye cac ha tra tai chinh dtrac cung cap theo chinh sach nay se dirge bao cao thtribug nien trong mAu IRS 990, Phu luc H.

BIDMC se ghi lai tat ca cac ho tg tai chinh de quail 13% mot cach thich hop va dap img tat ca cac yeu cau not bo lan ngoai bO.

Phu lyc 1

Mau clang 14 trq cap tai

Vui long in ra Bang 147 try cap tai chinh

Trung tam Y te Beth Israel Deaconess Chinh sach Ili) tra tai chinh Trang 20

chinh Ngay: S6 an sinh xd hei (SS) #

Se he so. sirc khoe:

Ten benh nhan:

Dia chi: Throng So nha

Thanh pho

Bang Md buu chinh

Ngay dich vu benh vien:

Ngay sinh cua benh nhan

Benh nhan co bao hiem y to hodc Medicaid** tai thei diem sir dung dich vu benh vien? C6 ❑ Khong ❑ Neu "Co", dinh kem ban sao the bao hiem (ca hai mat) va hoan thanh cac thong tin sau:

Ten cong ty bao hiem:

Se hieu gidy bao hiem:

Ngay c6 hieu luc:

Se dien thoai bdo higm:

**Truck khi clang k'S/ nhan ho tra tai chinh, quSi vi phai clang 4 Medicaid trixac 6 thang va xuat trinh chimg cir bi tit chei.

Luu S/: Ho try tat chinh có the khong dirgc ap dung rdu Tai khoan tie't kiem y to (HAS), Tai khoan boi hoan y to (HRA), Tai khoan chi tieu linh hogt (FSA) hodc cac guy- khac twang to dtrov sti clung cho cac chi phi y to gia dinh citrov lap. Viec chi tra tie cac qu51 dd lap có the Aviv gia hgn cho den trirac khi cac ho try dirg.c cung cap.

De 'Jana 10 ,nhan 118 tra tai chinh, dien cac thong tin sau: Danh sach tat ca ngueri trong gia dinh gem cha mc, con cdi va/hodc anh chi em runt, con de, con nuoi , dual 18 Mei dang sinh song tai gia dinh.

Ten thanh vien .. Tuoi Quan he voi benh nhan

). Nguon thu nhali ho4c Ten ngtriri sir clking lao dOng

1 Tong thu nhali hAng thang

1. 2. 3. 4.

Ben canh don dang 147 he trq tai chinh, chimg Col ding can qu51 vi dinh kem met s6 gidy tar sau khi &rig 14: • Ban khai thug thu nhap ca nhan hien taiCurrent state or federal income tax returns • W2 hien tai • Ben cuen lucmg gAn nhat • Ben bdo cdo hOa don hodc tai khoan Wet kiem gan nhat

Neu khong c6 nhung giay te ten, vui long goi den Dan vi to van tai chinh de thao ludn xem

Trung tam Y tg Beth Israel Deaconess CI -111.1h sach 116 tra tai chinh Trang 21

c6 the cung cap cac chimg tir Ichac dtrgc hay khong.

Bang chft ky dual day, toi xac nhan minh da doc ky Chinh sach ho trg tai chinh va Dang ky va moi thu toi not hoac nhimg chUng tir toi dinh kern la dung su that va chinh xac theo hieu biet cua toi. Tot hieu rang hanh vi co y gal cac thong tin sai su that de dwelt:5 trg tai chinh la hanh vi pham phap luat.

Chit ky cua ngtari dang ky:

Quan he yeti benh nhan:

Ngay hoan tat:

Neu thu nhap cua quy vi tang len bang bat ky each nao hoac quy vi bdo cdo mdc thu nhap 0.00 USD trong dang ky nay, tuyen bo ho trg (Support Statement) can phai dirge hoan chinh beri ngueri cung cap su h6 trg cho ban va gia dinh. Tuven bo 118 tra Toi da dtrgc benh nhan/ben lien quan xac nhan viec se ho trq tai chinh. Droll day la danh sach nhimg dich vu ma tot cung cap.

T6i cam doan va xac nhan nhang th6ng tin tren Id chinh xac va dung su that theo su hieu bier dm COL Toi hieu rang chit ky cua toi se khong khien toi phai chin trdch nhiem tai chfnh cho nhimg chi phi y to cua benh nhan.

Chit Icy:

Ngdy hoan tat:

Vui 16ng chef 30 ngay ke tir ngay nhan don dang ky de xem )(et tfnh du dieu kien. Neu du dieu kien, ho trg tai chinh se dugc cap cho benh nhan trong sau thang ke tir ngay chap thuan va flitting ho trg nay c6 hieu luc trong tat ca cac co so true thuOc dm Beth Israel Deaconess:

• Beth Israel Deaconess Medical Center-Boston • Beth Israel Deaconess Milton • Beth Israel Deaconess Needham • Beth Israel Deaconess Plymouth

Danh cho nhan vien Don nhan bed: BIDMC f=1 BID Milton ❑

BID Needham ❑

BID Plymouth ❑

Trung tam Y te` Beth Israel Deaconess Chfnh sach ho trg tai chfnh

Trang 22

Phu luc 2

Don dang 147 try cap kho khan y to

A A Dan 'Tang ksT trq cap kho khan y to

Vui long in ra

Ngay:

Ma SSN#

SO hO sa sirc khoe:

Ten benh nhan:

Ngay thong nom sinh cua benh nhan

Dia chi:

Direng s6 nha

Thanh phO

Bang Ma buu chinh

Benh nhan c8 bdo hiem y to hoac Medicaid tai tiled diem sir dung dich vu benh vien? CO ❑ Khong ❑ Neu "CO", dinh kern ban sao the bao hiem (ca hai mat) va hoan thanh cac th8ng tin sau:

Ten ding ty bao hiem:

Se hieu gidy bao hiem:

Ngay co hieu luc:

SO dien thoai bao hiem:

**Truac khi dang ky nhan 116 tra tai chinh, quy vi phai dang Icy Medicaid truac 6 thong va xuat trinh chimg cir bi tir choi.

Luu y: Ho tro' tai chinh có the khong duov cip clung n'eu Tai khoan tier kiem y to (HAS), Tai khoan boi hoan y to (HRA), Tai khoan chi tieu link hoot (FSA) hock cac guy" khcic twang to dttqc su clung cho cac chi phi y to gia dinh dei &eve lap. ,Viec chi tea tie cac qufi del lap có the &toy gia cho den trwac khi cac ho tea dleac cung cap.

De dang kV ,nhan try tai chinh, dien cac thong tin sau: Danh sach tat ca ngutri tong gia dinh gam cha me, con cai va/hoac anh chi em runt, con de, con nuoi, duai 18 tuoi dang sinh song tai gia dinh.

Ten thanh vien z. Tuoi Quan he v(ri cha/mg

Nguen thu nhap Mac Ten ngiroi sir dung lao Ong

Ping thu nhap hang thong

1. 2. 3. 4.

Trung tam Y to Beth Israel Deaconess Chinh sach hti tru tai chinh

Trang 23

Ben canh dcm clang ky trg cap kh6 khan y t6 (Medical Hardship), chung t6i cung can quy vi dinh kern mot s6 giAy ti sau khi dang • Ban khai thud thu nhap ca nhan hien taiCurrent state or federal income tax returns • W2 hidn tai • Bon cudn lucmg gAn nhat • &in ban cdo hda don hoac tai khoan tiet kidm gAn nhat • Ban sao tat ca cdc hoa don y t6

Neu kh6ng c6 nhang giAy to tren, vui long goi den Dan vi to van tai chinh than ludn xem cd the cung cap cdc chi:mg to Ichac clugc hay khong.

Danh sach cdc khoan ng y td va cung cap ban sao cua cdc hija don y to trong 12 than gan nhat:

Ngay sir dung ditch vu Noi sir dung dich vu Khoan ng

Vui long giai thich ngan gon vi sao nhang hda don y to nay gdy kh6 khan:

Bang chit ky duai day, t6i cam doan tat ca cdc thong tin dd dugc xac nhan trong don la dung theo cdc hieu biet, niem tin va cdc thong tin ma toi

Chit Icy dm ngulyi dang

Quan hd vai besnh nhan:

Ngdy hoan tat:

Vui long chi 30 ngay ke to khi nhan don dang Icy a xem xet tfnh du dieu kidn.

Trung tam Y to Beth Israel Deaconess Chfnh sach he) trg tai chinh Trang 24

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I:0 ed -4 c4. CD CD P.

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Y to B

eth Israel Deaconess C

hInh sach he, trq tai chinh

Phu lyc 3

Bieu de mire giam gia dtra tren thu nh4p

Chi tra ttrc Nhang benh nhan khong có ho trg chi tra tir ben thu ba khong du dieu kien nhan Ho trg cong dong hoac Ho trg tai chinh se dugc giam gia 30%. Viec thanh town phai dugc tien hanh trtrac khi sir dung cac dich vu. Mire giam gia nay cling se dugc dp dung cho cac benh nhan sir dung nhimg dich vu phi y te.

Dinh mire ngheo doi lien bang 2016 (FPL)

Household Size 100% 133% 150% 200% 250% 300% 400%

1 $11,880 $15,800 $17,820 $23,760 $29,700 $35,640 $47,520

2 16,020 21,307 24,030 32,040 40,050 48,060 64,080

3 20,160 26,813 30,240 40,320 50,400 60,480 80,640

4 24,300 32,319 36,450 48,600 60,750 72,900 97,200

5 28,440 37,825 42,660 56,880 71,100 85,320 113,760

6 32,580 43,331 48,870 65,160 81,450 97,740 130,320

7 36,730 48,851 55,095 73,460 91,825 110,190 146,920

8 40,890 54,384 61,335 81,780 102,225 122,670 163,560

Household size: Quy mo ho gia dinh Cu moi thanh vien tang them se dugc cong 4164 USD tali nam.

Giant gia 114 tro' tai chinh cho nhirng b?nh nhan dii diet' kqn:

Mitc thu nliki Clam gia It km hoac bang 200% FPL 100% - HO trg town be 201%-400% FPL 50% - HO trg mot phan

Gram gia kho khan y to cho nhirng benh nhan din dieu ki?n:

Benh nhan dugc xac dinh du tieu chuan nhan ho trg tir chtrcmg trinh trg cap kho khan y to (Medical Hardship) neu cac hoa don vien phi lan hon hoac bang 25% so vgi tong thu nhap va se nhan dugc mire giam gia la 65%.

Trung tam Y to Beth Israel Deaconess Chinh sach ho tra tai chinh Trang 26

Phu lyc 4

Nha cung cap dich vu bao hiem va y to

Chinh sach nay ap dung cho tat ca cac Benh vien (Khoa phong) nhu sau:

Dieu duong trong cac khoa: • Tiet nieu • Phdu thuat vu • Hiep hOi chain soc sire khoe (HCA) • Cham soc ung thu tien liet tuyen • San phis khoa • Thiet bi tim mach

Cac phong kham tinh phi theo benh vien: • Phong kham nguc da khoa • Huy& hoc/Ung thu-SC va 7F • Lieu phap nhan thirc than kinh • Don vi lien chuyen khoa ngue • Do thi luc • Ung this da • Kham giong not va phat am • Thu6c xucmg khop , • Trung tam y tocOng dong • Trung tam do thi luc Lexington • Phong kham trkrc trang - da khoa • Phong kham ban chan Chelsea (Chelsea Podiatry) • Trung tam Dich vu Ung thu town cau BID • Cham sOc kh6i u nao

Chinh sach nay khong &roc ap dung cho cac nh6m bac sr sau: • HOi bac si thuOc Khoa y Harvard (HMFP) • Hiep hOi cham soc sirc khoe (HCA) • Trung tam cham soc sirc khoe Beth Israel Deaconess (APG) • Nh6m Atrius Health Medical Group • HOi bac sr' thuOc khoa cap cdu dm BIDMC • HOi bac si cham sOc khan cap Chestnut Hill • Cac bac si hoac nhom bac si khac khong duoc neu a ten. Cac benh nhan can yeu ca‘u trkrc tiep vai bac si de nhan cac thong tin ve h6 tro tai chinh.

Trung tam Y to Beth Israel Deaconess Chinh sach hi) try' tai chinh Trang 27

Phy lyc 5

SO den thong thuirng thanh toil' (AGB)

M6- i IRS 501(r), benh vien phai gioi han chi phi cho cac benh nhan NIA dich vu dtro.c phep ap di,ing theo Chinh sach h6 trg ,tai chinh ,(FAP) cho S6 tien thong thuong thanh town (AGB) cho Nha cung cap Bao hiem thucmg mai va Medicare khi sir dung Phuang phap H6i ciru. BIDMC xac ,dinh AGB bang cach chia tong thanh town nhan ducyc co tong chi phi cho tat ca cac ke hoach Tai chinh va Chain soc y to (Commercial va Medicare plans) trong nam tai chinh gan ke. Cac tinh town bao Om mirc dong chi tra, Tong bao hiem va khoan khau trir cho benh nhan.

Vi du:

T6ng chi tra 510.000.000 USD = 51%

T6ng chi phi 1.000.000.000 USD

510.000.000 USD: T6ng chi tra 1.000.000 USD: T6ng chi phi AGB=51%

AGB co the thay d6i bat cir lac nao vi nhang 13'T do sau day: • Nhting thay doi trong hop d6ng Thuong mai va Cham s6c y to

(Commercial va Medicare contract) • NhUng khoan thanh town do Commercial plans va Medicare nhan

BIDMC se ding khai tat ca cac thay d6i ciia AGB truck khi ap dung no.

Trung tam Y t'e' Beth Israel Deaconess Chit -1h sach lui try' tai chinh Trang 28

Phy lkic 6

Truy cap tai lieu

Thong tin ve Chinh sach ho trq tai chinh cua BIDMC Financial Assistance Policy, Plain Language Summary (ban torn tat bang ngon ngir ca ban), Financial Assistance Application (Dang ky Ito trq tai chinh), Medical Hardship Application (Dang ky nhan ho trq ngheo khO y te) va Credit and Collection Policy (chinh sach thanh toan va truy thu cua BIDMC) se luon co cho cac benh nhan va khu vlrc ma BIDMC plivc vu thong qua nhieu nguon khac nhau, hoan toan mien phi.

1. Benh nhan va ngixeri bao lanh có the yeu cAu ban sao cua cac giay to lien quan den he' trq tai chinh va chinh skit thanh toan va truy thu qua email hoac nh4n -aye tiep tai dia chi:

BIDMC Dan vi to van tai chinh

East Campus/Rabb Phong 111

Boston, MA 02215

Dan vi to van tai chinh ding luon san sang a h8 trq benh nhan va ngtreri bao lanh trong viec hoan tat viec (tang ky nh4n ho trq tai chinh va dang1c3"/ nhlan trq cap ngheo doi y te.

2. Benh nhan va ngtreri bao lanh có the yeu c'au ban sao cua cac giAy to lien quan den Ito trq tai chinh va chinh sach thanh toan va truy thu qua so dien thoai (617) 667-5661

3. Benh nhan va ngtroi bao lanh có the yeu cAu ban sao cua cac gi'ay tedien quan den ho trq tai chinh va chinh sach thanh toan va truy thu qua trang web ding khai cua BIDMC: http://www.bidmc.org/patient-and-visitor-information.aspx

Chinh sach ho trq tai chinh cua BIDMC Financial Assistance Policy, Plain Language Summary (ban tom tat bang ngon ngit ca ban), Financial Assistance Application (DangkST ho trq tai chinh), Medical Hardship Application (Dang 14 nhan M trq ngheo kho y te) va Credit and Collection Policy (chinh sach thanh toan va truy thu cua BIDMC) ho trq cac ngon ngit: • Tien Anh • Tieng Trung (gian the) • Tieng Trung (phon the) • Tieng Tay Ban Nha • Tieng Nga • Tieng 136 Dao Nha • Tieng Viet

Trung tam Y te Beth Israel Deaconess Chinh sach hi) tro• tai chinh Trang 29

Ngay 9/2016

Hot Ong Chinh sach ducyc HDQT chap thuan

BIDMC da dang tai nhimg thong bao ve cac chinh sach ho try tai chinh hien có nhu da neu tai chinh sach thanh town va truy thu tai:

1. NOi tru , phong kham, khoa tiep nhan cap dru va.hoac tai khu vtrc cha/dang 14;

2. Khu vise co van tai chinh cho benh nhan; va 3. Khu vue phong kinh doanh ma cira cho benh nhan

Nhang tam poster nay kha de thAy (8.5" x 11") va de doc dai voi cac benh nhan tai nheing khu vuc nay va duac dich ra tieng Tay Ban Nha. Thong bao viet:

THONG BAO HO TRa TAI CHINH Trung tam y cung cap nhieu chuong trinh ho trg tai chinh cho nhQng benh nhan dit

dieu kien. De xem ban c6 dil diau kien nhan ht; trq tai chinh hay khong, vui long den van phong to van tai chinh cua chunktoi tai tang 1, Oa nha Rabb hoac goi den so 617-667-5661

de biet them thong tin ve cac chuong trinh.

Lich sir chinh sach

Trung tam Y te` Beth Israel Deaconess Chit -1h sdch ho tra tai chinh Trang 30