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Officials for Utah County's two largest hospitals say their doors are always open for those in need of health care - regardless of ability to pay for that care.

Mark Howard, executive director of Utah Valley Regional Medical Center, says: "We will work with anybody and try to help them out."As of Oct. 31, the medical center had written slightly more than $1 million in charity care off of total revenues of $90.8 million. Utah Valley, an Intermountain Health Care facility, is a non-profit hospital.

Steve Walston, director of Mountain View Hospital in Payson, said his facility groups can't specify exactly how much has been spent on such care this year; its "bad debt" averages $600,000 per year.

"Those who really don't have the ability to pay, we try to help them through Medicaid, Medicare and charity care," Walston said. "We work with individuals all the time."

Annual revenues at Mountain View are approximately $24 million, Walston said. Mountain View, an affiliate of HealthTrust Inc., is a for-profit hospital.

Neither hospital includes community-education programs or health screenings or tests in their charity or bad-debt figures. And, Utah Valley includes its charitable contracts with Timp Mental Health Center - less than $300,000 per year - in a separate category.

While officials say charity care is available for those who need it, they also acknowledge they carefully scrutinize such requests and make every effort to pursue payment from every patient.

"We have not turned anyone away who could not pay for care," said Larry Dursteler, Utah Valley's chief operating officer. "But, we have turned away people who have not needed care." Requests for cosmetic surgery, for example, are among those turned down.

Both hospitals require that candidates for charity care fill out a financial form listing personal assets and liabilities; the form is reviewed by hospital personnel who make a determination on an individual's ability to pay for hospital care. Utah Valley uses poverty income guidelines established by the U.S. Department of Health and Human Services to make charity-care determinations.

The guidelines allow anywhere from 100 percent to 25 percent of a bill to be dismissed as charity care depending on family size, income and circumstances.

Extenuating circumstances are also considered in making a determination, including size of the hospital charge in relation to a patient's financial status, medical status of the patient or his family and likely emotional and medical impact of the financial indebtedness upon the patient.

Howard said decisions on charity-care status are usually made within a few days and that charity-care patients receive the same level of treatment as paying patients.

"No hands-on provider should know (about a patient's financial status)," Howard said.

Mountain View, on the other hand, has no specific guidelines and relies on information provided by credit checks.

While the hospitals examine a family's income, bank accounts, entitlements to tax refunds, insurance payments, stocks and bonds etc. to determine ability to pay a hospital bill, officials said a patient would not be asked to sell a home, household property or a primary vehicle to cover charges.

"We have never taken a home, although it's legally possible," said Rod Lisenbee, financial officer at Utah Valley.

Mountain View Hospital also has not resorted to such drastic measures, Walston said.

However, hospital officials take a different view of recreational vehicles; officials may ask a patient if such items could be sold. And, they are not so kind when it comes to bad-debt situations or flagrant attempts to manipulate the system, Lisenbee said.

"Our services are very valuable and we have to make every effort to collect those monies or we won't be able to continue to provide our services," Lisenbee said. "Our obligation to the community and to our patients is not to burden them with excessive bad debts and write-offs."

Utah Valley pursues repayment through small claims court and through Credit Assurance Agency, an affiliate of Intermountain Health Care. Mountain View contracts with several local credit bureaus for payment collection.