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ATTACHMENT C
PATIENT NOTIFICATION Charity Care and Discounted Payment Programs
Consistent with its mission, Verity Health System
hospitals provide free or reduced cost medical services to
persons
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How to fill out charity care and discounted

How to fill out charity care and discounted
01
To fill out charity care and discounted forms, follow these steps:
02
Obtain the necessary application forms from the charity care or discounted program provider.
03
Read the instructions carefully to understand the eligibility criteria and required documentation.
04
Gather all the required documents, such as proof of income, residency, and identification.
05
Fill out the forms accurately and provide all the necessary information.
06
Attach the required documents to the application form.
07
Review the completed form and documents to ensure everything is correct and complete.
08
Submit the application form and documents to the charity care or discounted program provider by the specified deadline.
09
Follow up with the provider to confirm the receipt of your application and to inquire about the processing timeline.
10
Once your application is processed, you will be notified of the outcome and any further steps required.
11
If approved, ensure you understand the terms and conditions of the charity care or discounted program, including any obligations or limitations.
Who needs charity care and discounted?
01
Charity care and discounted programs are intended for individuals who are unable to afford regular medical expenses or treatments without financial assistance.
02
Those who may need charity care and discounted include:
03
Low-income individuals and families who do not have health insurance or have limited coverage.
04
Uninsured individuals facing high medical bills.
05
Individuals who are facing financial hardship due to unexpected medical expenses.
06
Individuals who are ineligible for government assistance programs or other forms of financial aid.
07
It's essential to review the specific eligibility criteria of each charity care or discounted program provider to determine if you qualify.
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What is charity care and discounted?
Charity care is when a hospital provides free or discounted medical services to patients who are unable to pay. Discounted care is when the hospital offers medical services at a reduced rate to patients in financial need.
Who is required to file charity care and discounted?
Hospitals and healthcare facilities are required to file charity care and discounted.
How to fill out charity care and discounted?
Charity care and discounted forms can be filled out by including information about the patient, their financial situation, the medical services provided, and any discounts given.
What is the purpose of charity care and discounted?
The purpose of charity care and discounted is to ensure that patients in financial need have access to medical services without facing financial hardship.
What information must be reported on charity care and discounted?
Information such as patient demographics, financial status, services provided, and discounts given must be reported on charity care and discounted forms.
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