Helping You Navigate Your Finances
Our Patient Financial Services personnel are able to assist in guiding through your financial responsibility, once your insurance has been billed. We know the cost of healthcare is concerning but we are here to help. Here is our Financial Assistance Policy. Here is a summary of the policy. Along with those policies, you may be interested in our billing and collections policy.
We offer the following:
Financial Assistance Program (HOPE)
Community Medical Center is committed to provide quality medical services to all patients regardless of their ability to pay. Our Board of Directors recognizes there is a need for financial assistance for some patients. The Helpful Options for Patient Expense (HOPE) Program has been established to provide financial relief or free service as charity care, according to income guidelines for patients residing in Richardson County, Nebraska and for patients with established long term primary care with a doctor in Falls City. The HOPE Program serves as the Hospital’s financial assistance, billing & collections, and emergency medical care policies.
There is an information on the HOPE program and some definitions you may need. Click here. (insert the hope-program pdf)
Amounts Generally Billed (AGB)
An individual who applies for and has been determined to be eligible for financial assistance will not be charged more than the amounts generally billed (AGB) to individuals who have insurance coverage for that same care.
Community Medical Center, Inc. will apply the “look-back method” for determining AGB. The look back method will include all claims that have been paid in full by Medicare and Commercial Health Insurers for emergency/medically necessary care provided by Community Medical Center, Inc. during a prior 12-month period.
The AGB will be determined by multiplying the Gross Charges for these claims by the AGB percentage. Gross Charges are defined as the full established rate for the provision of healthcare service and items. (Gross Charges x AGB Percentage = AGB)
The AGB Percentage is the sum of all amounts allowed on these claims divided by the sum of the associated gross charges for those claims.
AGB% = Sum of Claims Allowed Amount $ / Sum of Gross Charges $ for those claims
Amounts Generally Billed: 66%
Effective Date: August 1, 2022