Financial services

Lincoln Hospital is a nonprofit public hospital. Under federal law, if you have a medical emergency or are in labor you have the right to receive, within the capabilities of this hospital's staff and facilities:

• An appropriate medical screening/examination.
• Necessary stabilizing treatment (including treatment of an unborn child).
• Appropriate transfer to another facility, if necessary.

These services are available even if you cannot pay or do not have medical insurance or you are not entitled to Medicare or Medicaid.

Lincoln Hospital does participate in the Medicaid Program.

We are happy to assist you by billing your insurance company on your behalf. At the time of your registration or admission, we will ask you to sign an Assignment of Benefits which will allow us to receive payment directly from your insurance company. If you do not choose to assign benefits, you will be asked for payment in full or to make other arrangements (see above Payment Policy).

Lincoln Hospital accepts most major insurance plans. To find out if your carrier is on our list of insurances, please call us at 509.725.7101. Our service representatives are more than happy to assist you.

You may use your VISA, MasterCard or Discover to pay your accounts.

Lincoln Hospital contracts with Integra Business Solutions to manage our self-pay balances.

Integra is a nondeliquent self-pay account solution center that operates as an extension of our Patient Financial Service's billing department. Integra does not report accounts to credit reporting agencies and is not a collection agency. Integra utilizes skilled professionals to work with our patients to address their concerns and help them work toward account resolution.

Should you have a self-pay balance (balance after insurance or no insurance), you will receive a monthly statement from Integra and it is important that you make your monthly payment by the due date each month. All payments are made directly to the hospital and/or clinic you received your services from.

Lincoln Hospital District No. 3 is sensitive to your right to privacy, so be assured that the Integra financial staff is held to the highest of professional standards and deals with patient information with the utmost confidentiality.

If you are not able to pay your balance in full within 90 days after the first billing statement it will begin to accrue interest at 12 percent.

Prior to any visit, you should verify your benefits with your insurance company to make sure the visit (including surgery or medical procedures) is covered.

Pre-authorization is approval by your insurance company to proceed with a service (such as a CT scan or MRI) or a surgical procedure. We will make every attempt to ensure this pre-authorization has been obtained by the ordering provider. However, obtaining pre-authorization does not guarantee that your insurance company will pay the bill.

A denial is when your insurance company refuses to reimburse the medical charges by your doctor or hospital. We can circumvent this by submitting the claim without errors.

More and more insurance companies are denying charges as a standard practice in order to delay payments. However, we can circumvent this by submitting your bill without mistakes.

• Provide your insurance cards at each visit. We've found many insurance companies continually change their billing address.
• Keep us updated if you have any address or telephone changes.
• Speak with your insurance company and verify coverage, referral and pre-authorization prior to visits and procedures.
• Contact your insurance company or contact us if the insurance company wants any further paperwork or asks questions that you don't understand.
• Don't just pay a bill that your insurance company refuses to cover. Get your policy book out and look it over. We are happy to help you, so feel free to bring it to our office for assistance.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of- pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Starting January 1, 2020, Washington state law protects you from surprise or balance billing if you receive emergency care at any medical facility or when you’re treated at an in-network hospital or outpatient surgical facility by an out-of-network provider.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in- network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

Starting January 1, 2020, Washington state law protects you from surprise or balance billing if you receive emergency care at any medical facility or when you’re treated at an in-network hospital or outpatient surgical facility by an out-of-network provider.

When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in- network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact 1-800-985-3059.

Visit www.cms.gov/nosurprises for more information about your rights under federal law.

Visit www.insurance.wa.gov/what-consumers-need-know-about-surprise-or-balance-billing for more information about your rights under Washington state law.

Washington State requires all hospitals to provide financial assistance to people and families who meet certain income requirements. You may qualify for free care or reduced-price care based on your family size and income, even if you have health insurance.

• Patients with income between 0%-200% the Federal Poverty Level are eligible for a 100% discount
• Patients with income between 201%-250% the Federal Poverty Lines are eligible for a 75% discount.
• Patients with income between 250%-300% the Federal Poverty Lines are eligible for a 50% discount.

Patients over 300% of the Federal Poverty Level may be considered for Catastrophic Charity Care if medical expenses are equal or greater than 20% of the family’s annual gross income. Please contact Patient Financial Services for more details.

What does financial assistance cover? Financial assistance covers medically necessary services provided by our Hospital or one of our Clinics, depending upon your eligibility. Financial assistance may not cover all health care costs, including services provided by other organizations.

How is the application processed? In order for your application to be processed, you must:

• Provide us information about your family: Fill in the number of family members in your household (family includes people related by birth, marriage, adoption, or who live together)
• Provide us information about your family’s gross monthly income (income before taxes and deductions)
• Provide documentation for family income and declare assets
• Attach additional information if needed
• Sign and date the form

Note: You do not have to provide a Social Security number to apply for financial assistance. If you provide us with your Social Security number it will help speed up processing of your application. Social Security numbers are used to verify information provided to us. If you do not have a Social Security number, please mark “not applicable” or “NA.”

Mail or fax completed application with all documentation to: Patient Financial Services, Lincoln Hospital, 10 Nicholls St, Davenport, WA 99122. Fax: (509) 725-2112, Attention: Self-Pay Specialist . You may submit your application in person to the Admitting Desk at Lincoln Hospital, 10 Nicholls St., Davenport WA.

We will notify you of the final determination of eligibility and appeal rights, if applicable, within 14 calendar days of receiving a complete financial assistance application, including documentation of income. By submitting a financial assistance application, you give your consent for us to make necessary inquiries to confirm financial obligations and information.

Charity Care Application