FINANCIAL ASSISTANCE


    • Policy Summary

      About financial assistance

      Financial assistance is available for patients who receive medically necessary services and meet the eligibility requirements under the policy. If eligible for financial assistance, patients can receive up to a 100 percent discount. The financial assistance program does not cover elective services.

    • Am I eligible?

      Am I eligible?

      In order to qualify for financial assistance, all of the following conditions must be met:

      The patient must be uninsured or, in certain circumstances, have limited insurance coverage
      The patient must be unable to access other programs that would cover medical expenses
      The patient’s annual family income must be no more than 200 percent of the current year Federal Poverty Guidelines as adjusted annually. We also offers a discounted rate to patients whose family gross income is between 201% and 400% of the Federal Poverty Guidelines
      The patient must not have substantial cash assets
      The patient must not have declined health insurance through an employer
      The patient must not be ineligible for government sponsored coverage because of noncompliance with requirements
      The service must be considered medically necessary (generally defined as urgent or emergent)
      The patient must reside within a 25-mile radius of the facility where services
      The completed application and all supporting documentation must be submitted to the Patient Account Services department, during the applicable time period, for review and approval

    • How do I apply?

      How do I apply?

      Applications are available in English and Spanish. A copy of the Financial Assistance Policy and an application may be obtained by:

      Visiting the website at https://innervision.scdiag.com/patient-info/financial-assistance/
      Calling the toll-free Customer Service number at 877-250-9871
      Calling the toll-free Customer Service number on the front of your statement and requesting the Financial Assistance Application (copies will be mailed at no charge)
      Emailing a request to charitycare@patientfinancialsvcs.com
      Visiting the facility where services were rendered

    • How will I know if I am approved?

      Once all requested documents are received, the application will be reviewed. An approval or denial letter will be mailed to each applicant. The Financial Assistance Application and documentation must be updated every six months, or when the patient’s income or other key circumstances change. Each visit within the six month period is subject to be reviewed.

    • Exclusions

      Exclusions:

      This policy only applies to services rendered at St Francis Millennium, Innervision Medical Imaging Center, Innervision MRI & Imaging at Grove {it does not apply to services rendered by independent physicians or practitioners that are not employed by St Francis Millennium, Innervision Medical Imaging Center, Innervision MRI & Imaging at Grove}. This includes, but is not limited to, Radiologists.

      No individual who is eligible for financial assistance will be charged more than amounts generally billed for emergency or other medically necessary care to individuals who have insurance covering such care.