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Charity Care Screening
UC Davis Health
Hospital Policies and Procedures
Policy ID: 1891
Revised 07/31/2017Attachments (see end of document)Financial Assistance Program Plain Language SummaryPatient
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How to fill out charity care screening
How to fill out charity care screening
01
Gather all necessary personal and financial information.
02
Contact the organization or facility offering charity care screening.
03
Schedule an appointment for the charity care screening.
04
Attend the appointment and bring all required documents.
05
Fill out the charity care screening form, providing accurate information.
06
Submit the completed form along with any additional documents as required.
07
Wait for the organization to review your application and determine your eligibility for charity care.
08
Follow up with the organization to inquire about the status of your application if necessary.
Who needs charity care screening?
01
Individuals with limited income or financial resources
02
Uninsured individuals
03
Those who are unable to afford medical bills or healthcare services
04
Low-income families
05
Individuals facing unexpected medical expenses
06
People experiencing financial hardship due to medical conditions or treatments
07
Anyone seeking financial assistance for medical care
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What is charity care screening?
Charity care screening is a process used by healthcare providers to determine a patient's eligibility for financial assistance or charity care.
Who is required to file charity care screening?
Healthcare providers are required to file charity care screenings for patients who may be eligible for financial assistance.
How to fill out charity care screening?
Charity care screenings can be filled out by collecting information from patients such as income, household size, and assets.
What is the purpose of charity care screening?
The purpose of charity care screening is to help ensure that patients who are unable to afford healthcare services receive the financial assistance they need.
What information must be reported on charity care screening?
Information such as income, household size, assets, and the reason for seeking financial assistance must be reported on charity care screening forms.
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