Financial Counseling and Patient Financial Services Flashcards

What is the primary goal of financial counseling in the revenue cycle?

Answer: To help patients understand and manage their financial obligations for healthcare services

Financial counseling focuses on educating patients about their financial responsibilities and available assistance options so they can make informed decisions.

Which federal program provides health coverage to individuals with low incomes, including families, pregnant women, and people with disabilities?

Answer: Medicaid

Medicaid is a joint federal and state program that provides health coverage to low-income individuals and families who meet eligibility requirements.

A sliding fee scale in a financial assistance program bases a patient's discounted payment on which factor?

Answer: The patient's income relative to the Federal Poverty Level (FPL)

Sliding fee scales use a patient's income as a percentage of the Federal Poverty Level to determine the appropriate discount tier for financial assistance.

Under the Affordable Care Act (ACA), nonprofit hospitals that want to maintain tax-exempt status must have a written financial assistance policy (FAP). Which of the following is a required element of the FAP?

Answer: Eligibility criteria for financial assistance, including whether free or discounted care is available

The ACA requires nonprofit hospitals' FAPs to include eligibility criteria, the basis for calculating amounts charged, and how to apply for assistance.

What does the term 'charity care' refer to in healthcare financial services?

Answer: Care provided free of charge or at a reduced cost to patients who cannot afford to pay

Charity care is the provision of free or discounted healthcare services to patients who are unable to pay, based on their demonstrated financial need.

Which document is used by financial counselors to assess a patient's income, assets, and household size to determine eligibility for financial assistance programs?

Answer: Financial assistance application / charity care application

A financial assistance or charity care application collects income, asset, and household information needed to evaluate a patient's eligibility for assistance programs.

A financial counselor is helping an uninsured patient who is scheduled for a non-emergency procedure. What is the BEST first step the counselor should take?

Answer: Screen the patient for insurance coverage options and financial assistance eligibility

Screening for coverage options and financial assistance eligibility is the appropriate first step to identify all potential resources available to the patient.