Financial Assistance/Charity Care Program
Our mission is to make a positive difference in the lives and health status of all members of our community, especially those who are underserved and most vulnerable. We developed the Charity Care program to help meet the needs of our patients who are either uninsured or require assistance in meeting their financial obligations.
If you cannot afford to pay for part or all of your essential health care services, you may be eligible for this program. We also offer financial assistance for insured patients who need help understanding and paying deductibles, co-pays and coinsurance. If you’d like to talk with us about financial assistance options, please call (585) 368-6226.
The following are details about our Charity Care program. Select a link to jump to that section:
We believe that fear of a medical bill should never get in the way of essential health services.
- Our financial aid policies are consistent with our mission and values, and take into account each individual’s ability to contribute to the cost of care and our financial ability to provide that care.
- We are committed to communicating our Charity Care policies in a way that's clear, understandable and sensitive to our patients -- in a language appropriate to the communities and people we serve.
- Our debt collection policies reflect our mission and values.
- We work with government, payers, consumer groups, employers and others to find solutions to expand access to health care coverage to all New York residents.
- We expect eligible patients to access public or private insurance options in order to qualify for financial aid and expect all patients to contribute to their care based on their ability to pay.
- We maintain patient confidentiality in all aspects of our operations, including this program.
The following questions and answers outline our program's guidelines.
Do I need to be a U.S. citizen to be eligible for Charity Care?
You must be a U.S. citizen or non-resident who has lived in the U.S. for at least three months.
What if I don't have any insurance coverage?
If you don't have health insurance, we will assist you with the application process for Medicaid, Child Health Plus or other coverage. You must participate fully in all efforts to obtain any insurance for which you may qualify.
Which services are covered by the program?
Our Charity Care program covers all medically necessary services. We will never delay emergency or urgent health care pending a Charity Care determination. The program does not cover cosmetic services, long-term care inpatient services or television and telephone charges. Stays in the Timothy R. McCormick Transitional Care Center are only eligible for Phase II Financial Assistance discounts. In addition, if you do not comply with your insurance company requirements, we will not cover the resulting self-pay balances.
What if I don't know I need the program until after my stay?
Whenever possible, we make patients aware of financial responsibilities prior to providing services (with in-person conversations, or written notices or signage). If you did not apply for Charity Care prior to receiving services or if your circumstances changed afterward, you can apply for the program within six months of your visit.
The Charity Care program assists patients who cannot afford to pay in full for care. It is not a substitute for employer-sponsored, public or individually purchased insurance, and your ability to contribute to the cost of your care will be considered.
We start by assessing the responsible person’s annual household income and the number of people in the home, as a percentage of the Federal Poverty Guideline amounts published by the Department of Health and Human Services (updated annually).
If you fall within 400% of the guidelines, you will receive a discount on your Health System charges. The amount will either follow the Unity Health System Financial Assistance fee scale or be equal to the Medicaid DRG, APG Base rate plus capital add-on or Medicaid fee schedule, whichever is less. The discount amount for dental services will follow the Unity Health System Financial Assistance fee scale.
If you do not fall within 400% of the poverty guidelines, you will be required to submit additional information regarding your income, liquid assets and expenses.
We also consider the size of your financial obligation. The program is designed so that you are not expected to spend more that 20% of your income or 10% of your assets (generally liquid) for qualifying health care obligations.
If you have exhausted your insurance benefits and/or exceeded our financial eligibility criteria but face extraordinary medical costs, we will work with you on a case-by-case basis.
Certain levels of patient responsibility are maintained so that:
You are responsible for the amount remaining after we apply the Charity Care discount. We will help you make arrangements to pay any remaining balance on the account(s), which may involve a payment plan.
- The Charity Care program or health services are not abused.
- Funding remains available.
- We maintain our financial ability to provide care to the community.
Financial assistance application
To apply for financial assistance or Charity Care, please complete this application and mail to:
100 Kings Highway South
Rochester NY 14617
To effectively communicate our Charity Care program, Unity Health System:
- Provides consumer-friendly communications.
- Notes the program availability and contact number on bills and department materials sent to patients prior to their visit. You can request a brochure in our registration areas.
- Posts program notices in key areas throughout the Health System with instructions for obtaining applications and/or additional information.
- Educates patients through the registration or financial counseling process about their responsibilities, potential financial obligations, requirements for completing eligibility documentation and our bill collection policies.
- Makes certified application counselors, Medicaid liaisons or financial counselors available to provide assistance in applying for insurance coverage.
2. Staff training
- We train new staff members during orientation and provide mandatory training for all staff members annually. Our patient registration staff receives additional education on explaining the process and directing patients to an appropriate financial counselor or patient account representative for further assistance. Financial counselors and patient account representatives receive detailed training on all aspects of our program’s policies and procedures.
3. Program administration
- We communicate in a way that is easily understood, respectful and promotes appropriate access to care. Our documentation requirements are easy to follow and include items such as pay stubs, income declaration, tax returns, rent receipts and medical bills. And our staff processes applications consistently, correctly and in a timely manner.
- If you don't have insurance coverage, our financial counselors will make every effort to determine your insurance and/or Charity Care eligibility during your stay in the Hospital. Please feel free to contact a financial counselor or the Patient Accounting Department to learn more.
Once we receive your referral, we will conduct a financial assessment. If appropriate, we will refer you to a Medicaid liaison/certified application counselor to complete an application for coverage. These liaisons will help you throughout the Medicaid application/determination process. They can also assist with the fair hearing process.
If you are not eligible to apply for insurance or if you are unable to obtain sufficient insurance coverage, you may apply for Charity Care. Applications may be submitted by patients, guarantors, guardians or Powers of Attorney. We accept applications prior to, during or within six months of your service date.
Once we receive an application, we will determine your eligibility and the qualifying discount amount. We may request additional documentation or information. We will process your request and provide your determination within 10 business days of your submission.
You may be approved for Charity Care on an account-by-account basis or for a period of up to six months. You will be required to update your financial information after six months if you still need Charity Care.
You or your representative may request reconsideration either by phone or in writing if additional information is available that would change your application. We will send a letter indicating the outcome of the reconsideration within 10 business days of the request.
You will continue to receive bills and statements during the application process; however, we do not expect payment until your Charity Care determination is made (as long as you submit the required information within set timeframes).
If you refuse to provide the required documentation or comply with other aspects of the process, you will not be eligible for Charity Care and you will be responsible for all Hospital charges related to your care.
Unity Health System works with patients to establish a reasonable payment plan. If you or your representatives do not fulfill your payment obligations within the specified time periods, we will refer your account to a collection agency.
Legal action, including the garnishment of wages, may be taken when there is evidence that you or the responsible party has income and/or assets to meet your financial obligations. Unity will not force the sale or foreclosure of your primary residence to pay an outstanding medical bill when you are being considered for Charity Care.
We maintain a written agreement with each collection agency we retain. These agencies are required to follow Health System guidelines when pursuing payment. Accounts referred to agencies are subject to standard collection practices.
If you inquire about the Charity Care program during the collection agency process and it is still within the eligible timeframe to apply, you will be referred to the Patient Accounting Department.
We provide the Health System Board with detailed information regarding the Charity Care program. The Board will determine if additional guidelines are needed, if necessary.