Transcript GHC Sponsored Care Program The Group Health Sponsored Care Program (SCP) GHC Sponsored Care Program OVERVIEW The GHC Sponsored Care Program (SCP) is for GHC.

GHC Sponsored Care Program
The Group Health
Sponsored Care Program (SCP)
2005
GHC Sponsored Care Program
OVERVIEW
The GHC Sponsored Care Program (SCP) is for
GHC patients in financial need.
Patients are screened for SCP based on
 Enrollment status
 Medically necessary hospital visits at Central or Eastside Hospital
 Household income
 Liquid Assets
 Exceptions
SCP does not consider expenses or accumulated medical bills.
GHC Sponsored Care Program
OVERVIEW
SCP consists of two programs for low-income
patients:
Charity Care Assistance is for all patients - enrolled or not - who
need help with bills for care received at licensed GHC hospitals
(Eastside or Central), plus related follow-up care. Patients must have
income at or less than 200% of the Federal Poverty Level.
Health Care Assistance is a short-term program for GHC enrollees
who need help with inpatient and outpatient fees, copays,
prescription costs, (and other sub programs). Patients must have
income at or less than 250% of the Federal Poverty Level and meet
specific enrollment criteria. Assistance includes:
 6 past months of unpaid GHC bills
 6 months of future GHC copays and fees.
GHC Sponsored Care Program
OVERVIEW
Why does SCP exist?
Charity Care laws exist in Washington which require hospital systems
to provide free-of-charge care to indigent (<= 200% FPL) patients,
regardless if they are enrollees or not.
Also, if GHC and collection agencies can’t collect owed money from
GHC enrollees, unpaid bills are usually written off to bad debt.
SCP is the alternative for low-income patients. Once SCP reviews
and approves an application, Group Health stops billing the patient
and waives normal fees by writing them off to a charity care account
rather than bad debt. This supports Group Health’s non-profit status
and core mission values of Respect, Integrity and Stewardship.
GHC Sponsored Care Program
FLOWCHART
DOES patient meet SCP Financial
Guidelines?
NO SCP assistance
available.
NO
YES
SCP can waive GH bills less than
6 months old, and future GH bills
for outpatient services &
medications for 6 months.
YES
Then
ask
Has patient been continuously
enrolled at least 6 months in an
individual, family or GH
employee plan? (New enrollees
must have paid at least 6 months’
dues).
YES
SCP can waive dues paid directly
to GHC for up to 6 months back
and 6 months forward.
Is patient
currently NO
enrolled in
Group
Health?
Has patient
never been
enrolled, or YES
disenrolled
for more than
6 months?
NO
NO
SCP cannot
waive GHC
dues.
SCP can
waive fees
incurred up to
6 months prior
to
disenrollment.
HEALTH CARE ASSISTANCE
SCP can waive
GH emergency
and follow-up*
bills for Central
and East campus
UCC, ED,
outpatient and/or
hospital inpatient
care (if patient
was admitted
from ED).
* Patient may
schedule follow-up
visits at a GHC
primary care clinic.
CHARITY CARE
GHC Sponsored Care Program
RESOURCES
The SCP Website includes:
 Referral and eligibility criteria
 SCP department processes
 Details on what SCP waives
 FAQS & Training resources.
 SCP Forms for download
 In-house resources (tipsheets, other department links, etc.)
 Internet resources (for seniors, community, specialty health, etc.)
Make sure to visit at: http://incontext.ghc.org/scp/.
 In InContext: check under ‘Departments/Patient Services’ or in
‘Departments/Alphabetic’.