St. Luke's Hospital - Financial Assistance Policy
St. Luke's Hospital provides care to patients consistent with its mission and values. Financial Assistance is available to those who reside in the community we serve, who are uninsured or underinsured and do not have adequate financial resources to pay for necessary healthcare services provided. Financial assistance does not apply to internationally traveling/vacationing patients who seek treatment at St. Luke's Hospital. Non-US citizens and US citizens living outside the USA are not eligible for financial assistance; this includes patients on a visa and international students. This does not include undocumented individuals living in the US. St. Luke's Hospital will use its best efforts to provide financial assistance fairly and consistently, balancing our patients' needs for financial assistance with St. Luke's Hospital's broader fiscal responsibility, and taking into consideration each patient's specific needs. Information gathered to determine whether a patient qualifies for Financial Assistance is kept confidential and is limited to only those directly involved with the determination process and is considered "protected health information" (PHI) under HIPAA.
Charity is defined as the demonstrated inability of a patient to pay, versus the unwillingness of a patient to pay. The Financial status of a patient is determined through the financial assistance application process and/or from information obtained from outside parties to distinguish a patient's ability to pay. All patients seen at St. Luke's Hospital are expected to contribute to the cost of their care, based upon their individual ability to pay.
Charity Care includes services provided to:
- Uninsured patients who do not have the ability to pay based on criteria provided on the financial assistance application
- Underinsured patients whose coverage is inadequate to cover a catastrophic situation
- Insured patients with balances remaining due to deductibles, coinsurance or copayments
- Persons whose income is sufficient to pay for basic living costs but not medical care, and those persons with generally adequate incomes who are suddenly faced with catastrophically high medical bills
- Patients who demonstrate the ability to pay part but not all of their liability
- The hospital will not discriminate based on race, ethnicity, gender, age, disability, etc., or on the basis of source of payor, when making financial assistance determinations
- The hospital will apply the policy uniformly to all hospital patients and is applicable to all hospital patients, including inpatients and outpatients who reside in the communities we serve.
- A family member or estate executor may apply for financial assistance on behalf of a deceased patient.
Charity Care excludes services such as convenience items, cosmetic procedures or service provided that are not medically necessary.
Determination for eligibility for full or partial charity will remain valid for twelve months from the date of charity determination for all necessary hospital services and will be applied to current episode of care and unpaid balances.
Patients may apply for Financial Assistance at any time before, during or after their care. The application requires proof of income which includes a federal tax return for all adults in the household, Social Security Income (SSI), pension statements , paycheck stubs, alimony and child support documentation, and/or declaration of income from their supporter. Patients who do not file a tax return will need to provide proof of residency. If data provided by a patient requires greater clarification than what is provided, St. Luke's may contact the patient's employer, the IRS or other sources with the patient/guarantor's consent to validate the data. Patients may also be asked to obtain written validation of data provided for consideration of financial assistance. If upon receipt of the application, all of the required documentation is not received, St. Luke's will contact the patient by phone or a follow up letter will be mailed requesting the additional information needed to complete the processing of the application.
If there is a change in financial circumstances within a twelve-month period, an updated or new financial assistance application may be completed. Patients who have had a change in income due to a job change, loss of a job, or reduced hours/inability to work for a period of 3 months or more can reapply and will be considered for financial assistance based on their current income. Patients will need to provide documentation supporting the change in income ie: previous year tax return along with W2, three months current paycheck stubs, letter from employer stating employee's current status and pay, disability letter, unemployment, etc...
Patients are expected to cooperate with the hospital's procedures for obtaining insurance and other forms of payment and to contribute to the cost of their care based on their individual ability to pay. Individuals with the financial capacity to purchase health insurance shall be encouraged to do so, as a means of assuring access to health care services, for their overall personal health, and for the protection of their individual assets. The hospital will exhaust all payment options including, but not limited to local, state and Federal Assistance programs (ie: completing a Medicaid application) and requiring patients to seek in-network care, before considering an application for financial assistance. Charity care discounts will not be applied to patient accounts who have elected to receive services at St. Luke's and are out of network with their insurance plan. Prior to financial assistance discounts being applied, all other resources must be applied first, including applicable health insurance coverage, payment from third party payors, and payments from Medicaid and Medicaid HMO plans. If funds are provided to the patient to purchase insurance coverage are used for basic living needs and can be documented as such, including current level of income based on Federal Poverty Guidelines, consideration of financial assistance will not be based on lack of insurance coverage.
Amounts charged to financial assistance eligible patients will not exceed Amounts Generally Billed (AGB) to patients with medical insurance. Patients can contact Patient Financial Services to obtain the current AGB. Patients without insurance who receive services at the hospital will automatically be eligible for a 40% discount and are eligible to apply for a financial assistance. Patients without insurance who receive services at St. Luke's Medical Group will automatically be eligible for a 33% discount and are eligible to apply for financial assistance.
Financial Assistance Applications
Patients may request an application for financial assistance through Social Services, Patient Billing, or any St. Luke's
employee who, if unable to directly assist the patient, can direct them to the appropriate personnel. Applications are available in the hospital, at all registration areas and the cashier's office as well as on-line via the hospital website:
Download Financial Assistance Application
Applications can also be obtained free of charge by mail or by calling 314-576-8100. Applications are available in English, Spanish, Bosnian, Chinese and Korean and interpreters are available free of charge. Patients who need assistance completing an application can call 314-576-8100 Monday – Friday 8:30 a.m. – 5:00 p.m.
Financial Assistance applications will be reviewed, and a determination will attempt to be made within 14 business days from receipt of all appropriate information. Patients are asked to comply with providing supporting documentation to assist in the determination process. A patient's failure to provide all requested information may result in a delay of determination. St. Luke's
will contact the patient by phone, or a letter will be mailed to the patient requesting the missing documentation. The letter will provide the address for the patient to send the documentation, a deadline, and a phone number to call if the patient has questions. Only one application is necessary and consideration will be taken for multiple accounts for the patient/guarantor. If a patient qualifies for a partial reduction in their account balance but is not able to pay their remaining balance in full, an interest free payment plan is available so that patients can pay through monthly installments. If a patient is unable to provide the requested documentation, please call 314-576-8100 to inform us why the documents are not able to be provided.
Hospital reaches out to self-pay and underinsured patients in a number of ways, including raising patient awareness of Medicaid health insurance. By assisting our patients with the application process, St. Luke's
Hospital helps patients obtain the benefits for which they qualify. A Financial Counselor may contact you during your stay in the hospital or after you are discharged to assist you in the application process.
Financial Assistance Determination
Financial Assistance is based on a sliding scale, taking into consideration the following: Federal Poverty Guidelines, income, assets, family size, medical need and catastrophic costs. Patients who are between 0% - 400% of the Federal Poverty Guidelines will qualify for a financial assistance discount. Financial assistance discounts range between 25% - 100% and is available to all patients regardless of whether they have health insurance. Patients who have health insurance may qualify for assistance on their remaining balance (coinsurance/deductibles) after insurance pays.
All other resources must be applied first, including applicable health insurance coverage, payment from third party payors and payments from Medicaid, Medicaid HMO plans, or other government sponsored programs. Patients are required to seek in-network care. Financial assistance will not be applied to non-emergency services for patients who see care out-of-network.
Financial assistance is available to all hospital patients including inpatients, outpatients and those receiving services at one of our off-site or affiliate locations.
Determinations for eligibility for full or partial charity will remain valid for twelve months from the date of the charity determination for all necessary hospital services and will be applied to current episodes of care and unpaid balances.
There are instances when a patient may appear eligible for financial assistance, but there is no application on file due to lack of supporting documentation. Often, there is adequate information provided by the patient or through other sources, which would provide sufficient evidence to provide the patient with financial assistance. St. Luke's
Hospital may use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility. Patients who have been awarded a discount less than 100% using the hospitals Healthcare Scoring Tool (HFST) may submit an application for financial assistance to see if they are eligible for a larger discount.
Nothing in this policy will prohibit St. Luke's
Hospital from offering reduced or more favorable financial assistance to an uninsured patient based upon individual circumstances.
See physicians who are covered under St. Luke's Hospital's Financial Assistance policy
See physicians on St. Luke's Medical staff who are not covered under St. Luke's Hospital's Financial Assistance policy
Uninsured Patients Billing Practices
The first statement sent to an uninsured patient will reflect a self-pay discount in the amount of 40% (medically necessary services only). The discount will be applied to services that are considered medically necessary, denied as non-covered, exceeded the allowed length of stay or exhausted benefits.
When sending a bill to a patient, the following statement will be included:
- Financial Assistance may also be available to those who have an inability to pay because they are uninsured or lack other financial resources. An application must be completed to determine eligibility. Please contact our Customer Service Department for more information.
St. Luke’s Hospital management has developed policies and procedures for internal and external collection practices that take into account the extent to which the patient qualifies for charity, a patient’s good faith effort to apply for a governmental program or for charity from St. Luke’s Hospital, and a patient’s good faith effort to comply with his or her payment agreements with St. Luke’s Hospital. For patients who qualify for financial assistance and who are cooperating in good faith to resolve their hospital bills, St. Luke's Hospital may offer extended payment plans, will not impose wage garnishments or force a foreclosure on primary residences, will not impose actions that force bankruptcy and will not send unpaid bills to outside collection agencies. Unpaid balances will not be reported to the credit bureau until at least 6 months from placement date and only if patients are not cooperating with paying their balance.
St. Luke’s Hospital adheres to the laws of the Fair Debt Collection Practices Act and the Association of Credit and Collection Professional's Code of Ethics and Professional Responsibility and patients are treated with dignity, respect and in line with our mission and values.
Patients are informed about our Financial Assistance process in a number of ways:
- Financial counselors and Social workers are available to patients during their stay.
- Patient Financial Services attempts to contact scheduled patients prior to services to provide patients with their expected amounts due and discuss payment/discount options.
- Discussions about financial assistance occur when speaking to patients on the phone about their account balances.
- Information regarding our Financial Assistance Policy is located on our website, our billing statements as well as our registration booklets/brochures and signage in all registration areas.
- St. Luke's Pediatric Care Center is a mission-based agency of St. Luke's Hospital that provides health care to children in St. Louis City and County in a private practice setting where care is available for uninsured and low-income children.
- St. Luke's Hospital partners with Volunteers in Medicine in our primary service area and People's Health Clinic in our secondary service area which addresses the healthcare needs for those with low income. Information about our financial assistance policy is communicated to members of our community through advertisements that are mailed to approximately 68,000 homes which promote classes and events that we offer in the community. Signs informing patients about our Financial Assistance Policy are posted in all registration areas and off-site locations (approximately 50 locations). Patients can also find our policy and application information on all billing statements as well as our website.
- Applications are available free of charge by mail or phone and can be obtained on our website.
Financial Assistance Policy is subject to change from time to time without notice.