The aim of psychiatric treatment at Riggs is to help individuals take charge of their lives and return to better outpatient functioning despite limitations with which they may grapple. The cost of treatment can be seen as both a reality and a metaphor for other limitations and difficult choices individuals face. Attention to the practical and emotional consequences of these limitations, including financial limitations, is often a useful part of treatment. We routinely include patients and their families (if they are paying for treatment) in discussions about the cost of treatment and the available financial resources prior to admission and during treatment.
The purpose of this Financial Assistance Procedure is to provide information about issues related to payment for treatment, including how we manage the funds the Austen Riggs Center has budgeted for fee reductions in order to provide consistent decision-making in the fee reduction determination process. The Center’s fee reduction budget is funded through a combination of general operations, annual donations, and income from a donor-restricted patient aid endowment fund. This Procedure is subject to revision from time to time without notice.
Because of the specialty focus of the Center, insurance coverage may be more restrictive for services provided by the Center than for services provided in a general hospital psychiatric unit. In addition, the Center is not a Medicare or Medicaid provider. The Center’s staff members work with patients and families to obtain approval for treatment from insurance companies, but cannot guarantee the outcome of those efforts. Patients are encouraged to work with their treatment team to design the most cost-effective course of treatment that meets their clinical needs within the resources available. Financial assistance provided by the Center is based on need. All patients who come to the Center are expected to contribute to the cost of their treatment, based upon their ability to pay.
Austen Riggs Center provides fee reductions resulting in discounted care (and in select circumstances reduction of the advance payment requirement) for patients who are uninsured or underinsured and do not have adequate financial resources to pay for their treatment at the Center.
How to Apply for Financial Assistance
A fee reduction application is completed by the patient and all responsible parties. Fee reduction applications are also available from the Admissions Office, (800) 51-RIGGS (74447), which is open from 8:30 a.m. – 5:00 p.m. Monday through Friday. Completion of the fee reduction application includes providing all supporting documentation requested to assist in the determination process. A patient’s failure to provide all requested information may result in a delay or denial of financial assistance. If you have questions regarding the financial assistance application process, please call Todd Morin, Accounting Manager at (413) 931-5286.
How We Make the Financial Assistance Determination
Fee reduction determinations are based on need, taking into consideration factors such as income, assets, family size, medical needs and medical indigence, insurance status, other financial commitments of the patient and/or other responsible parties, all viewed in the context of the patient’s treatment plan. Fee reductions are generally granted only for days not covered by health insurance.
Patients are urged to submit fee reduction applications and supporting documentation before admission or as soon after admission as possible. In some cases those not eligible for a fee reduction for the initial period of 6 weeks of evaluation and treatment may be eligible for one if they stay beyond the evaluation and treatment phase. All fee reductions are reviewed at least annually. Patients may re-apply for fee reductions in the event of a significant change in financial resources or treatment plan. A re-application requires an update to the original application and the resulting fee reduction determination may either increase or decrease the amount of assistance offered.
A 3% prompt payment discount is available to those who are not otherwise eligible for a fee reduction except when fees are paid by credit card.
In the event of non-payment of accounts, the Center may take steps to collect the amount due, including contacting the patient or responsible party by telephone or mail to request payment, sending the account to the Center’s legal counsel for review and collection, filing lawsuits, reporting to credit agencies, and taking any other collection or reporting action in accordance with applicable law.
For patients who qualify for fee reductions as described above, and who adhere to the terms of any fee reduction offered, the Center will not invoice or attempt to collect from such patients any fee amount other than the reduced fee amount. For patients who are cooperating in good faith to resolve their accounts, the Center may offer extended payment plans.
The Center informs its patients and responsible parties about the Center’s Financial Assistance Procedure in a number of ways, including:
- Discussing treatment costs and financial assistance options with patients prior to admission and during treatment;
- Providing patients with a copy of this Procedure upon admission;
- Including information in invoices and in other written communications regarding where this Procedure may be viewed, who to contact for further information and how to apply for financial assistance;
- Reminding patients (or other responsible parties) of this Procedure when speaking with them about their account balances; and
- Posting this Procedure on the Center’s website and in areas at the Center.
January 1, 2013