Financial Assistance Information

Cannon Memorial Hospital provides quality healthcare to all patients presenting for care regardless of their ability to pay.  This policy defines the financial guidelines for charity adjustments to the self pay portion of low-income and medically indigent patient account receivable and also establishes discounts available to patients with no means of third party coverage.

Prompt Pay Discount:

A twenty-percent discount is available from the discharge date thru the thirtieth day.  A ten percent discount is available from the thirty first day thru sixtieth day past the discharge day.  If the patient receives a discount and the form of payment is returned for NSF the discount will be reversed.  These discounts are for patients having no form of third party coverage.  Discounts must be requested by the patient and approved by the Business Office Manager.  The discount will not be given until the full negotiated payment is received from the patient. 

Low Income Adjustment: 

Cannon Memorial Hospital recognizes three (3) Assistance/Charity Programs available for qualified patients. 

  1. The M.I.A.P Program (Medically Indigent Assistance Program) is for patients admitted to the Hospital as an Inpatient.  The patient must apply for the M.I.A.P program and receive approval for assistance through their county.  Cannon Memorial will consider providing 100% assistance on outpatient services.
  2. Cannon Memorial Hospital offers an uncompensated Assistance Program for both inpatient and outpatient services which are determined to be medically necessary.  The patient must apply for Medicaid and receive a denial for Government assistance prior to applying for the Cannon Memorial Hospital assistance program.
  3. The Samaritan Health Clinic of Pickens County (Free Medical Clinic) is for patients who present to the Clinic and need other diagnostic testing.  These are approved and referred to Cannon Memorial Hospital on an individual basis.

Procedure:

A.  All patients who wish to apply for financial assistance through Cannon Memorial Hospital must provide proof they do not qualify for Medicaid or any other government assistance.

B.  Assistance/Charity care will be based on the following criteria:

  1. Completed application
  2. Individual or family income (signed income tax return)
  3. Individual or family net worth, bank statements checking and savings (liquid assets)
  4. Employment status and earning capacity
  5. Family size
  6. Real estate
  7. Personal property
  8. Drivers license or official ID
  9. Other information requested

C:   At the time of determination of eligibility the hospital will:

  1. Discontinue all billing and collections efforts on the approved amount
  2. Adjust the patient receivable by writing off the account as charity using the appropriate adjustment code.
  3. Maintain a log of approved adjustments

Sliding Scale:

A.  Income eligibility will be determined using the most current Federal Poverty Guideline.

B.  Patients that fall under 100% of the federal income poverty guideline will be considered for a 100% write-off of qualifying charges.

C.  Patients that fall between 100%-200% of the income poverty guideline will be considered for the write-off according to a sliding scale.

D.  Patients that are over 200% of the federal income poverty guideline will not be eligible for financial assistance unless there are extenuating circumstances, in which case the hospital CEO or CFO may make a determination based upon catastrophic or financial hardship.

E.  The required information must be provided to the facility by the patient or the patient’s power of attorney.   Cannon Memorial Hospital provides assistance to all qualified patients in completing the required application.  The application cannot be completed if the date of service is over one (1) year old.  The patient must be a citizen of the United States and a resident of the state of South Carolina.  The required information must be provided for each of these program applications, and all guidelines and minimum requirements must be met to receive partial or full assistance in either program.

F.  The current sliding scale is available in the Fiscal Services Department of Cannon Memorial Hospital.

To obtain an application for financial assistance, call (864) 898-1242.