Financial Assistance
NOTICE OF FINANCIAL ASSISTANCE
No person, regardless of ability to pay, will be refused emergency medical
services in accordance to Internal Revenue Section 501(r)(4).
Application forms are available at the Patient Access Registration Desk and at the Patient Financial Services Department. Click here to download the form. For more information, please contact the hospital’s Patient Accounting Clerk at 810-648-6199.
Financial Assistance Policies
- Amounts Generally Billed
- Eligible Providers
- Ineligible Providers
- Emergency Medical Care Policy
- Financial Assistance Program -Charity Care- A-4-5-6
- Plain Language Summary
The hospital provides a Financial Assistance program for patients that have no insurance or who have out-of-pocket expenses that exceed their financial abilities.
Charges are covered as follows:
- Eligible Charges include emergency, non-elective hospital inpatient/outpatient charges and medically necessary outpatient testing
- Non-Eligible Charges include elective (scheduled) surgery and procedures and non-McKenzie charges
The general eligibility requirements are as follows:
- Family income must not exceed 250% of the federal poverty level
- Family cash assets must not exceed program limits
- Patients who may be eligible for coverage under Medicaid/Healthy Michigan must have applied within the last 6 months and been denied coverage. A copy of the denial letter should accompany the application for Financial Assistance.
Patient Responsibility for Payment
Payment for services provided is the responsibility of the patient or their legal guardian. Patients are responsible for payment of their account balance regardless of any insurance coverage they may have.
Payment Accepted. McKenzie accepts cash, check, Visa, MasterCard and Discover.
Returned Check Fee. The non-sufficient fund/returned check fee is $35.
Billing Information. Please be sure to confirm your billing information with the registration staff.
Update them with any changes such as changes to:
- Insurance Coverage
- Address
- Phone number
- Employment status
- Name
- Marital status
Insurance Coverage. McKenzie participates with many insurance companies. It is the responsibility of the patient to verify that McKenzie participates with their carrier before services are rendered. Patients are responsible for knowing and understanding the terms and requirements of their insurance plan. This includes financial obligations for co-pays, deductibles and co-insurances; pre-authorization certification; and specific laboratory requirements. Co-pays, deductibles, and co-insurances are due at the time of service.
Applying for Medicaid
You can apply for coverage under Medicaid and/or Healthy Michigan on-line at www.healthcare4mi.com. More information, contact the Department of Human Services office, 515 S. Sandusky Road, Sandusky, MI 48471. The phone number is 810-648-4420.
For help completing an application or for more information, contact the McKenzie Social Worker at 810-648-6181.
Hospital Related Charges
Structured Payment Arrangements. The hospital offers payment arrangements with a minimum of $50 per visit payable in monthly installments.
Account Balance Term Monthly Payment
- Less than $300.00 6 Months $50.00
- $301.00 – $600.00 8 Months $75.00
- $601.00 – $1,000.00 12 Months $85.00
- $1,001.00 – $2,400.00 24 Months $100.00
- $2,401.00 – $6,000.00 48 Months $125.00/_template/236240/16367278
- $6,001.00 – $9,000.00 60 Months $150.00
- Over $9,000.00 – Director of Patient Financial Service Approval
Call the Financial Services Department at 810-648-6199 for more information.
Deposit Requirements. The hospital requires a minimum deposit of 50% of the Patient Responsibility Estimate for patients that request non-emergency surgical, treatment room or specialty testing (including CT, nuclear medicine, stress tests, ultrasound/echo).
Other Payment Options. Advomas can evaluate patients with large hospital bills and who have no insurance for any third party programs or payment options such as Workers Compensation, Veterans, No-Fault Auto Insurance, Crime Victims, Medicaid appeals, etc. These advocate services are provided at no cost to the patient. For more information, contact the Patient Financial Services Department 810-648-6199. In addition, the Health Insurance Marketplace helps uninsured people find health coverage. Visit www.HealthCare.gov or call 1-800-318-2596.
Office Related Charges
Our primary care offices participate in a Sliding Fee Scale Program. No one will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule based on family size and income. For more information, please ask if your physician participates in the program. More information is available by downloading our Financial Policy Brochure.
All of our Clinics adhere to the policies of the National Health Service Corps. Download a copy HERE.