651 West Marion Rd
Mt. Gilead, OH 43338
(419) 946-5015

• Residency Requirement – The patient must be voluntarily living in the state of Ohio.
   
• Service Date
  1. Outpatient Services. Eligibility determination is effective for 90 days from the initial service date, during which time a new eligibility determination need not be completed. Effective date for outpatient eligibility is to be documented on each account, under system notes.
       
  2. Inpatient Services. Eligibility determination will be performed separately for each admission, unless the patient is readmitted within 45 days of discharge for the same underlying condition.
      
• Services must be a medically covered service per ODJFS guidelines.
   
• Patient must meet the income guidelines of at or below 100% of the current Federal Poverty Income Guidelines at the time of service.
   
• Family Size – Based on all dependents living in the household
  Patient cannot be a recipient of Medicaid or any other state Medicaid program.
   

DISABILITY ASSISTANCE:

• The ODJFS determines eligibility and distributes DA cards to covered individuals.
   
• Eligibility for recipients of disability assistance must be verified on a monthly basis for both inpatients and outpatients.
   
• Patient cannot be a recipient of Medicaid or any other state Medicaid program.

HOSPITAL CHARITY:

• Residency Requirement – At the time of treatment, the patient must be a resident of Morrow County or one of the surrounding counties of Crawford, Delaware, Knox, Marion or Richland.
   
• Service Date
  1. Outpatient Services: Eligibility determination is effective for 90 days from the initial service date, during which time a new eligibility determination need not be completed. The effective date for outpatient eligibility is to be documented on each account, under system notes.
      
  2. Inpatient Services: Eligibility determination will be performed separately for each admission, unless the patient is readmitted within 45 days of discharge for the same underlying condition.
      
• Service must be a medically covered service per ODJFS guidelines.
    
• Income Guidelines:
  1. Patients with income less than 100% of the current Federal Poverty Income Guidelines qualify for the HCAP program. (Refer to HCAP section on Page 1 of this policy)
      
  2. Patient must meet the income guidelines of 101% - 175% of the current Federal Poverty Income Guidelines at the time of service for a 100% charity adjustment.
      
  3. Patients must meet the income guidelines of 176% - 200% of the current Federal Poverty Income Guidelines at the time of service for a 75% discount.
      
  4. Patients must meet the income guidelines of 201% - 225% of the current Federal Poverty Income Guidelines at the time of service for a 50% discount.
      
  5. Patients must meet the income guidelines of 226% - 250% the current Federal Poverty Income Guidelines at the time of service for a 25% discount.
      
  6. These discounts are applied via the Financial Aid Discount Worksheet (available from the CFO or the Business Office). Due to the Federal Poverty Income Guidelines changing annually, Morrow County Hospital routinely updates this worksheet.
      
• Family Size – Based on all dependents living in the household
   
• Patient cannot be a recipient of Medicaid or any other state Medicaid program.

HARDSHIP:

Discounts for hardship will be reviewed on a case-by-case basis and may be granted at the discretion of the Chief Financial Officer and the Patient Accounts Manager.

NOTIFICATION OF FINANCIAL ASSISTANCE:

Signs are posted at each patient registration location stating our compliance with the State of Ohio’s Hospital Care Assurance Program (HCAP). Additionally the signage contains reference to the Morrow County Hospital’s Charity Program. Information materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. Also, billing statements include information regarding HCAP and a financial assistance application to apply for the HCAP or Morrow County Hospital Charity Program.

OTHER DISCOUNTS:

In order to encourage prompt payment, Morrow County Hospital offers a 15% discount on true self-pay accounts (no insurance) for which payment is received within 30 days of bill date. A 10% discount is available for co-payments or deductibles received within 30 days of bill date.


It is the policy of Morrow County Hospital that related parties of the hospital are not entitled to additional discounts other than as described above. Related parties include, but are not limited to, the following groups and their families and associates: Morrow County Hospital employees, Trustees, Medical Staff members, and vendors. Employees violating this policy through the offering of additional discounts, waiving of co-pays and deductibles or the improper write-off of an account will be subject to disciplinary action.