As a baby, Terry Lange's granddaughter, Eliza, was in the hospital sick five weeks and was not expected to live. Her parents had insurance to help them pay the large bills, and Eliza is now about to turn 6 years old.
With or without insurance, though, Eliza would have gotten the care she needed, said Lange, director of reimbursement for Intermountain Health Care's Utah County hospitals. And she would have gotten it without her parents having to dodge phone calls from the collections department.
IHC and most other hospitals offer charity care, or free services, to patients and their families who cannot afford the bills or their insurance co-pay, have no insurance, or whose insurance benefits are used up.
"A lot of (patients) think they can't pay so they don't answer us, they don't give us the opportunity to help them," Lange said.
Lange and Elizabeth Heath, manager of eligibility services for the Utah Department of Health, will answerquestions about accessing health care without insurance or sufficient funds Saturday from 10 a.m. to noon as part of the monthly Deseret News/IHC Health Hotline.
In 2000, IHC's 22 hospitals and affiliated programs provided about $32.8 million in charity care on more than 95,000 cases. That averages to a little over $344 per case. Lange said how much coverage a patient receives varies, but no one is turned away.
"It is the intent of IHC to provide care to anyone who needs it," he said of the program, which has been running since 1978.
During a patient's stay, financial counselors or eligibility workers often start the charity care application, but those who have already left the hospital can retroactively apply as well. Based on Internal Revenue Service forms, monthly income and Social Security checks, workers determine how much a patient is able to pay. In some cases that amount is nothing. Workers also ask potential recipients to exhaust all other possibilities for money, including state programs, family and church, said Terri Otten, eligibility counselor.
Charity care is a last resort, but not impossible to obtain, Lange said. The important part is for patients to contact him or one of the staffers about it, because otherwise collections workers are obligated by law to make a valid effort to get money from patients.
"We need to have you come and talk to us," he said. "Let us figure out with you for you."
Lange also noted that as of October 2001, military personnel who were in service for 20 years or more became eligible for the TRICARE for Life program. The federal government has promised to pay for remaining bills after Medicare benefits have been utilized, Lange said.