Financial Assistance Policy | Hackensack Meridian Health   

Financial Assistance Policy

HMH Hospitals Corporation
Administrative Policy Manual

Financial Assistance Policy #: 1845

Effective Date: January 2016 amended & combined January 1, 2018 for HMH Hospitals Corporation formation

Purpose:

To identify the governing rules for the collection of all fees associated with facility patient care rendered at HMH Hospitals Corporation (to be referred to as “Hospitals” from this point on) and the processes for interaction between the patient, guarantor, and the Hospitals’ Customer Service and Registration staff.

The adherence to this policy will result in the uniformity of Hospitals’ revenue collections while maintaining the reputation for which Hospitals is known. Adherence to this policy will also increase awareness of the financial assistance options available to eligible patients needing emergency or other medically necessary care and outline the procedures by which these patients can apply for financial assistance.

The focus will be to improve communication with our patients, to increase price transparency, increase cash collections pre-service, and significantly improve patient/public relations by providing our patients with the information they need to understand the price of their care. Additionally, Hospitals endeavors to increase access to its services by providing greater access to coverage by all members of the
community.

HMH Hospitals Corporation; HMH Hospitals Corporation (Hospitals’ medical centers include: Bayshore Medical Center, Carrier Clinic Behavioral Health Facility, Hackensack Meridian Health -Long Term Acute Care Hospital (LTACH), Hackensack Meridian JFK Johnson Rehabilitation Institute, Hackensack Meridian Johnson Rehabilitation Institute at Ocean University Medical Center, Hackensack Meridian Johnson Rehabilitation Institute at Riverview Medical Center, Hackensack University Medical Center, JFK Medical Center, Jersey Shore University Medical Center, Ocean University Medical Center, Old Bridge Medical Center, Palisades Medical Center, Raritan Bay Medical Center, Riverview Medical Center & Southern Ocean Medical Center.  These providers have established a mission to meet the medical needs of the communities it serves. A sound financial policy committed to reasonable credit and collection protocols, as well as comprehensive financial assistance options, is critically important and fundamental to Hospitals’ mission. HMH Hospitals Corporation will maintain a policy of price transparency by communicating financial responsibility to its patients prior to services rendered excluding emergency and trauma services. The policy will always be respectful of its patients’ financial situations and preserve the dignity of those involved, consistent with applicable New Jersey law governing NJ Hospital Care Assistance Program (Charity Care), P.L. 1992, Chapter 160

Please note that in accordance with the Emergency Medical Treatment & Active Labor Act of 1986 (EMTALA), persons with emergency medical conditions will be screened and stabilized regardless of their ability to pay. Such services will not be delayed, denied, or otherwise qualified for any reason, including, but not limited to, inquiries related to payment. See Administrative Policy 558-1, Patient Transfer and Emergency Medical Treatment & Active Labor Act (EMTALA).

A. Upfront Collections – General Patient Population

Policy:

For the purpose of this policy, “self-pay portion” for insured patients is defined as the amount owed by the patient (and/or guarantor) for all accounts as defined by the payer. The term Compassionate Care Rate is defined as the self-pay rate for uninsured patients. The term “facility” refers to prices for the “use of this facility” and not prices for the physician’s office or physician fees. The term “cost share” refers to a deductible, coinsurance, or co-payment amount

Generally, a patient and/or guarantor will have a self-pay liability under the following circumstances:

  1. The patient has no health care coverage for facility services.
  2. The patient has health care coverage for facility services; however, the service to be rendered is not covered by his or her health care coverage (example, cosmetic surgery).
  3. The patient has health care coverage, however, upon verification of the health care coverage, it is determined that the patient has a cost share amount due. This amount may come in the form of an annual deductible, applicable coinsurance, or co payment for facility services rendered.
  4. The patient has a penalty for out-of-network services (HMHN Hospitals are non-participating for a specified network). This penalty is imposed by payers when a patient is treated by an out of network facility and/or physician. The penalty will vary based on the patients’ hospital coverage. To increase transparency in out-of-network health care services HMH will disclose to patients whether the facility is in-network or out-of-network in respect to the patient’s health benefits plan; advise patients that, if the facility is in-network, the patient will not incur any out of pocket costs outside of those typically applicable to an in-network procedure, unless the patient knowingly, voluntarily, and specifically selects an out-of-network provider to provide services; inform patients that, if the facility is out-of-network, the patient will have a financial responsibility applicable to health care services provided at an out-of network facility.
  5. The patient has exhausted his or her health care coverage for the current benefit period (benefit year, calendar year, and/or lifetime maximums).

If a patient/guarantor has facility health care coverage one should use the following guidelines for determining and/or collecting self-pay balances:

  1. Medicare Inpatient Deductible for the applicable calendar year as outlined by CMS.

  2. Medicare Outpatient Coinsurance

    If the patient is not covered by a secondary insurance, the coinsurance amount as indicated on Hospitals APC Payment Schedule must be collected. The correct amount can be found in the “Coinsurance” column. If the service rendered does not appear on the APC listing, refer to the appropriate Medicare Fee Schedule based on the service rendered (Rehabilitation Medicine, Mammograms, MICU/AMB, Clinical Lab, Diabetes Education, etc.)

    Please advise the beneficiary that this is an estimated out-of-pocket expense. If the liability is greater, the patient will be billed for balance. If it is less than the collected amount, the patient will be refunded the excess amount.

  3. Medicaid
    Generally, there are no recipient/patient out-of-pocket expenses for covered services. Based on the Medicaid level of coverage, however, there may be an out-of-pocket expense for coinsurance and/or a non-covered service.

  4. Blue Cross and Blue Shield Coverage
    Confirm the patient’s responsibility or out-of-pocket expense/price by verifying electronically (RTE - Real Time Eligibility or payer website) or contacting Blue Cross. Verify if there is a patient responsibility and/or a non-covered service. Obtain the cost share amount and inform the patient. The Emergency Trauma Center (“ETC”) co payment amount should be verified via RTE Eligibility
    Verification or by accessing the payer website. If unable to verify via RTE or the payer website, the co payment amount can be found on the patient’s insurance identification card. As a last resort, contact the corresponding payer directly.

  5. Commercial and Managed Care Payers
    Confirm patient’s responsibility or out-of-pocket expense/price by verifying electronically (RTE or payer website) or contacting the payer. Verify if there is a patient responsibility and/or a non-covered service. Obtain the cost share amount and inform the patient. The ETC co payment amount should be verified via RTE Eligibility Verification or by accessing the payer website. If unable to verify via RTE or the Payer website, the co payment amount can be found on the patient’s insurance identification card. As a last resort, contact the corresponding payer directly.
  1. Inpatient Elective Admissions, Same Day Surgery and Outpatients in a Bed (Scheduled Visits)
    1. Patients, with or without insurance must be financially cleared:
      1. Prior to or on the date of pre-admission testing; or
        No later than 12:00 Noon, three (3) business days prior to the procedure

        The term “financially cleared” refers to insurance verification, the collection of all out-of-pocket expenses for all patients and the attainment of all required pre-certifications, authorizations, and/or referrals for those patients with insurance. For those with insurance, out-of-pocket expenses may include deductibles, coinsurance, and co-pay amounts, as well as all costs that are excluded from coverage (non-covered procedures). For those without insurance, out-of-pocket expenses are subject to the HMH Hospitals Corporation Compassionate Care rates.

        If a patient is not financially cleared within the stated time frame, the Clinical Director or Administrator for the service area will be notified and will subsequently make a determination as to the medical necessity of the patient’s condition regarding the procedure/test.

    2. Pre-admissions
      HMH Hospitals Corporation will pre-register all elective services when possible. The method of payment should be identified prior to the patient being admitted, including self-pay portions and prior outstanding balances. Financial assessments will occur prior to the patient’s scheduled procedure. If necessary, a financial agreement will be secured prior to the patient’s scheduled procedure based on the payment alternatives outlined in this policy beginning in Section B (5).

  2. Outpatient Elective Self-pay
    Patients, with or without insurance must be financially cleared no later than 12:00 Noon, three (3) business days prior to the procedure.

    The term “financially cleared” refers to insurance verification, the collection of all out-of-pocket expenses for all patients and the attainment of all required pre-certifications, authorizations and/or referrals for those patients with insurance. For those with insurance, out-of-pocket expenses may include deductibles, coinsurance and copay amounts as well as all costs that are excluded from coverage (non-covered procedures). For those without insurance, out-of-pocket expenses are subject to HMH Hospitals Corporation Compassionate Care rates.

    If a patient is not financially cleared within the stated time frame, the Clinical Director or Administrator for the Service Area will be notified and will subsequently make a determination as to the urgency of the patient’s condition regarding the procedure/test.

  3. Urgent Inpatient Admissions/Transfers/Direct Admits Benefit eligibility and verification will take place at time of admission for patients that are admitted to HMH Hospitals Corporation as urgent, answers or direct admits.

  4. Emergency Trauma Center (ETC)

    HMH Hospitals Corporation will continue to triage and treat the patient’s medical condition before any financial payment arrangements are discussed. HMH Hospitals Corporation will not deny service in the ETC. After verifying that the patient has been screened, stabilized and approval has been given by the patient’s clinician, the patient will be approached to collect the out-of-pocket patient responsibility.

    HMH Hospitals Corporation will bill all health care coverage including Medicare, Medicaid and third party payers, after eligibility verification.

  5. Managed Care Agreements – Patients with Insurance HMH Hospitals Corporation has specific managed care agreements. The patient’s responsibility will be determined by the third-party payer. The dollar amount will be calculated using the contracted rate agreed upon with the payer.

    Please refer to Appendix A of this policy for Hospitals’ Patient Collections Timeline for further information regarding the collection process and compliance with Internal Revenue Code §501(r)(6).

B. Financial Assistance Policy

For cases involving the treatment of qualified children or Medicaid patients, please refer to Administrative Policy 1846, Financial Assistance Policy NJ Hospital Care Assistance Program (Charity Care)/Medicaid).

Please note that not all services provided within Hospitals’ facilities are covered under this policy. Please refer to Appendix B for a list of providers by department that provide emergency or other medically necessary healthcare services within the hospital facility. This Appendix specifies which
providers are covered under this policy and which are not. The provider listing will be reviewed quarterly and updated, if necessary.

  1. Hospitals Compassionate Care I Discounting Policy: When the Compassionate Care I Rate is applied to an account at the time of bill creation, the total amount due will be based on the Inpatient and Outpatient Self-Pay Compassionate Care rates for the services rendered. The Inpatient Compassionate Care rates are the Medicare DRG rates for the current year. The Outpatient Compassionate Care rates are based on the Medicare APC Rate times one or the Medicare Fee Schedule Rate times one depending on the services rendered.

    Compassionate Care II
    For uninsured patients that do not qualify for Medicaid or NJ Hospital Care Assistance Program (Charity Care) and their income is not in excess of 600 % of the Federal poverty level.

    HMH will apply our Compassionate Care II Rate which is 50% of Medicare’s rates for the current year. Both Inpatient and Outpatient Services will be reduced to 50% of current Medicare DRGs and/or appropriate fee schedules.  Most recent Tax returns must be provided to capture household income.

    Compassionate Care III

    Definition: Discounting Patients Deductibles and Coinsurance Amounts based on need.

    If a patient's income is less than 600% of the Federal Poverty Level and he/she indicates it is not possible to pay the outstanding amount with an interest free payment plan over an extended period: a reduction of 50% of the amount owed will be considered with proof of income. Most recent Tax returns must be provided to capture household income.

    These are the final rates. No further discounts will be applied to these rates. However, no FAP eligible individual will be charged greater than Amounts Generally Billed (“AGB”) (defined later). An application to receive Compassionate Care is not required. This discount represents the self-pay portion of the uninsured or eligible insured patient.

  2. New Jersey State 15 Discounting Policy
    Effective 2/4/09, uninsured patients whose family income falls between 300% and 500% of Federal Poverty Guidelines will be screened using our current NJ Hospital Care Assistance Program (Charity Care) Screening process. Once qualified, revise the primary payer to “Q76” – “New Jersey State 15 Care”. The Inpatient New Jersey State 15 Care rates are the Medicare DRG rates for the current year. The Outpatient New Jersey State 15 Care rates are based on the Medicare APC Rate times 115% or the Medicare Fee Schedule Rate times 115% depending on the service rendered.

    Self-Pay after Insurance balances (deductibles, coinsurances, and copays) will not be discounted, unless the patient otherwise qualifies under this policy.

  3. Amounts Generally Billed (“AGB”) Calculation for Emergency or Other Medically Necessary Care

    In accordance with Internal Revenue Code §501(r)(5), in the case of emergency or other medically necessary care, patients eligible for financial assistance under this Policy will not be charged more than an individual who has insurance covering such care.

    An individual deemed eligible for financial assistance that requires emergency or other medically necessary care will be charged the lesser of the amount as calculated per B (1-2) above.

    Bayshore Medical Center, Carrier Clinic Behavioral Health Facility, Hackensack Meridian Health -Long Term Acute Care Hospital (LTACH), Hackensack Meridian JFK Johnson Rehabilitation Institute, Hackensack Meridian Johnson Rehabilitation Institute at Ocean University Medical Center, Hackensack Meridian Johnson Rehabilitation Institute at Riverview Medical Center, Hackensack University Medical Center, JFK Medical Center, Jersey Shore University Medical Center, Ocean University Medical Center, Old Bridge Medical Center, Palisades Medical Center, Raritan Bay Medical Center, Riverview Medical Center & Southern Ocean Medical Center. AGB is calculated utilizing the prospective payment method and equals Medicare Fee for Service rates.

  4. Forms of Payment

    Hospitals accept the following forms of payment:

    1. Cash
    2. Money Order
    3. Selected Credit Card- Visa, MasterCard, American Express, Discover
    4. Debit Cards with the Visa or MasterCard Logo
    5. Bank Check
    6. Personal Checks
    7. Wire transfer

  5. Hospitals Financial Agreement Plan Financial agreements can be established upon request. A minimum deposit is to be taken and the balance thereafter can be placed on an interest free installment plan.

  6. Financial Agreements for Accounts with Outstanding Balances All arrangements will be initiated using the Financial Agreement Payment form. One copy goes to the patient if requested.

  7. Financial Assistance Programs - New Jersey Medicaid or NJ Hospital Care Assistance Program (Charity Care) All patients that are unable to pay the Hospitals Compassionate Care I, II, or III rates will initially be referred to a Financial Counselor. If the Financial Counselor is unable to financially clear the patient, the patient will be referred to the Financial Assistance Unit. This unit will determine if the patient qualifies for one of the entitlement programs.

  8. International Patients Policy (Foreign Patients):

    Hospitals International Patient Definition:

    Patients currently residing in a foreign county and who are traveling to the U.S. to receive treatment at HMH Hospitals Corporation for specific services. These services are pre-arranged, and are NOT subject to the Financial Assistance provisions outlined in this policy.

    All international patients who pre-arrange to come to Hospitals from foreign countries to receive prearranged medical treatment will receive an approved reimbursement rate for services including, but not limited to:

    • Cardiology
    • Organ transplant Programs
    • Oncology
    • Orthopedics
    • Urology Procedures
      These patients will be pre-scheduled for these visits, at which time arrangements for a wire transfer of funds (including the wire transfer phone#) to cover the treatment. The wire transfer of funds must be made five (5) business days prior to the patient’s visit to Hospitals. Any portion of the prepayment that is not used will be refunded.

C. Applying for Financial Assistance

  1. Available Languages

    The Medical Center’s FAP, Application and Plain Language Summary (“PLS”) are available in English and in the primary language of populations with limited proficiency in English (“LEP”) that constitute the lesser of 1,000 individuals or 5% of Hospitals’ primary service area. These documents are available on Hospitals’ website as well as free of charge upon request.

  2. View & Print information on Hospitals’ Website

    Website: An individual can view information about financial assistance online at the following website:

    www.hackensackmeridianhealth.org/en/Pay-Bill/Financial-Assistance

  3. Application

    An individual can apply for financial assistance by filling out a paper copy of the application. The paper application is available free of charge by any of the following methods:

    a) By Mail: By writing to the following address and requesting a paper copy of the financial assistance application:

    • Carrier Clinic Behavioral Health Facility: Attn Patient Financial Services department- 252 County Road Belle Mead, NJ 08502
    • Hackensack University Medical Center patients 100 First Street - Suite 300 Hackensack, NJ 07601
    • Palisades Medical Center - 7600 River Road, North Bergen, NJ, 07047
    • JFK University Medical Center - 65 James St, Edison NJ 08820
    • Hackensack Meridian JFK Johnson Rehabilitation Institute - 65 James St, Edison NJ 08820
    • Johnson Rehabilitation Institute At Ocean University Medical Center- 425 Jack Martin Boulevard, Brick, NJ 08724
    • Jersey Shore University Medical Center, Ocean Medical Center, Old Bridge Medical Center, Riverview Medical Center, Southern Ocean Medical Center, Bayshore Medical Center, and Raritan Bay Medical Center - 1945 Route 33, Neptune NJ, 07753

  4. b) In Person: By stopping by the Financial Assistance Department in person (Monday thru Friday, 8:00AM-4:00 PM), located at the following address:
    • Hackensack University Medical Center,100 First Street - Suite 300 Hackensack, NJ 07601
    • Palisades Medical Center, 7600 River Road, North Bergen, NJ, 07047
    • JFK University Medical Center - 65 James St, Edison NJ 08820
    • Hackensack Meridian JFK Johnson Rehabilitation Institute - 65 James St, Edison NJ 08820
    • Jersey Shore University Medical Center, 1945 Route 33, Neptune, NJ, 07753
    • Johnson Rehabilitation Institute At Ocean University Medical Center - 425 Jack Martin Boulevard, Brick, NJ 08724
    • Ocean Medical Center, 425 Jack Martin Boulevard, Brick, NJ 08724
    • Old Bridge Medical Center, One Hospital Plaza, Old Bridge, NJ 08857
    • Hackensack Meridian Health - Long Term Acute Care Hospital (LTACH) -530 New Brunswick Avenue Perth Amboy, NJ 08861
    • Riverview Medical Center, 1 Riverview Plaza, Red Bank, NJ 07701
    • Southern Ocean Medical Center, 1140 Route 72 W, Manahawkin, NJ 08050
    • Bayshore Medical Center, 727 N Beers St, Holmdel, NJ 07733,                
    • Meridian Family Health Center, 1828 W Lake Ave # 202, Neptune, NJ, 07753
    • Jane H Booker Family Health Center, Neptune, NJ, 07753
    • Booker Behavioral Health Center, Shrewsbury, NJ,
    • Behavioral Health Center, 61 Davis Ave, Neptune, NJ, 07753
    • Raritan Bay Medical Center, 530 New Brunswick Ave, Perth Amboy, NJ

      1. By Phone: The Financial Assistance Department can be reached at 551-996-3990 Carrier Clinic Behavioral Health Facility, 551 996-4343 Hackensack University Medical Center, 201-854-5092 Palisades Medical Center, or 732-902-7080 all other locations

  5. Application Period:
    An individual has two years from the date they are provided with the first post-discharge billing statement to apply for financial assistance. Incomplete applications are not considered, but applicants are notified and given an opportunity to furnish the missing documentation/information.

  6. Completed Applications:
    Please mail all completed applications to the Financial Assistance Department (refer to address above, also listed on billing statements). Only data provided by the applicant will be used in approving financial assistance.

    APPENDIX A: HMH Hospitals Corporation Patient Collections Timeline- For Both Inpatient and Outpatient Services.


    Hospitals provide billing statements for services rendered after insurance has processed the claim. Balances after insurance include the following:

    1. Self-Pay (patient without insurance)

    2. Self-Pay after Insurance (insurance has satisfied their responsibility; the remaining balance is patient responsibility)

    3. Hospitals NJ Hospital Care Assistance Program (Charity Care) (compassionate care – discounted charges)

    4. Self-Pay after Medicare (patient responsibility as defined by Medicare).
      For those patients without insurance a statement is mailed approximately four days after discharge or date of service.

Non-Medicare Statement Cycle – The total billing cycle is 62 days before the balance is sent to collection. A bill is sent to patients after insurance has satisfied their portion. Payment in full must be received by the due date stipulated on the statement. If the total past due is not received by the due date, the patient will continue to receive subsequent statements (up to three in total). If payment is not received, a final pre-collection letter will be sent to the patient requesting payment within ten days. If payment is still not received, the account will be referred to a collection agency.

Medicare Statement Cycle – The total billing cycle is 120 days before the balance is sent to collection. A bill is sent to patients after Medicare and any secondary insurances have been paid. Payment in full must be received by the due date stipulated on the statement. If the total past due is not received by the due date, the patient will continue to receive subsequent statements (up to four in total). If payment is not received, a final pre-collection letter will be sent to the patient requesting payment within ten days. If payment is still not received, the account will be referred to a collection agency. If at any time within the 120-day period a partial payment is made, an additional 120 days is granted before the balance is sent to collection.

Address for patient payments follow:

  • Carrier Clinic Behavioral Health Facility- PO Box 950008467, Philadelphia, PA 19195-0001
  • Hackensack University Medical Center, P.O. Box 48027, Newark NJ 07101-4827 
  • Palisades Medical Center, 7600 River Road, North Bergen, NJ, 07047
  • JFK University Medical Center, 65 James St, Edison NJ 08820
  • Hackensack Meridian JFK Johnson Rehabilitation Institute, 65 James St, Edison NJ 08820
  • Jersey Shore University Medical Center, Neptune, NJ, Box 416765, Boston, MA 02241-6765
  • Johnson Rehabilitation Institute At Ocean University Medical Center, 425 Jack Martin Boulevard, Brick, NJ 08724
  • Ocean Medical Center, Brick, NJ, Box 416765, Boston, MA 02241-6765
  • Old Bridge Medical Center, Old Bridge, NJ, Box 416765, Boston, MA 02241-6765
  • Hackensack Meridian Health - Long Term Acute Care Hospital (LTACH) - PO Box 950008412, Philadephia, PA 19195-0001
  • Riverview Medical Center, Red Bank, NJ, Box 416765, Boston, MA 02241-6765
  • Southern Ocean Medical Center, Manahawkin, NJ, Box 416765, Boston, MA 02241-6765
  • Bayshore Medical Center, Holmdel, NJ, Box 416765, Boston, MA 02241-6765
  • Meridian Family Health Center, Neptune, NJ, 07753 Box 416765, Boston, MA 02241-6765
  • Jane H Booker Family Health Center, Neptune, NJ, 07753 Box 416765, Boston, MA 02241-6765
  • Booker Behavioral Health Center, Shrewsbury, NJ, Box 416765, Boston, MA 02241-6765
  • Behavioral Health Center, Neptune, NJ P.O. Box 416765, Boston, MA 02241-6765
  • Raritan Bay Medical Center, 530 New Brunswick Ave, Perth Amboy, NJ. Box 416765, Boston, MA 02241-6765

Patients with inquiries regarding their balance may call Customer Service at 551-996-1960

Extraordinary Collection Actions may include, but are not limited to, the following: commencing a civil action against an individual, entering judgment against an individual, placing liens on an individual’s property, and reporting adverse information to credit agencies. Extraordinary Collection Actions do not include any lien that a hospital is entitled to assert under state law on the proceeds of a judgment, settlement or compromise owed to an individual (or his or her representative) as a result of personal injuries for which a hospital provided care. Extraordinary Collection Actions are governed by the following time periods and will begin only after reasonable efforts were made to determine if the patient is FAP eligible.

  • Notification period: Hospitals shall notify the individual about the Collection, Payment, and Financial Assistance Policy before initiating any extraordinary collection actions to obtain payment and refrain from initiating extraordinary collection actions for at least 120 days from the date the patient is provided the first post-discharge billing statement for care.

  • Application Period: An individual has two years from the date they are provided with the first post discharge billing statement to apply. If at any time within the application period an application is submitted, ECAs will be suspended.

  • Waiting time for extraordinary collection actions: Hospitals must provide the patient with a minimum of thirty (30) days’ notice before engaging in any extraordinary collection actions.

Prohibited Collection Practices.

Hospital, Collection Agencies and Outside Counsel:

  • Will not force the sale or foreclosure of an individual’s primary residence to pay for an outstanding debt.
  • Will not engage in collection activity against an individual who was eligible for Medicaid at the time services were rendered and for which Medicaid payment is available, provided the individual has submitted a completed application for Medicaid in connection with such services.
  • Will not engage in collection activity against an individual approved for 100% NJ Hospital Care Assistance Program (Charity Care).
  • Will not sell an individual’s debt to a third party.
  • Will not institute legal action against an individual unless it is determined that an individual is able but unwilling to pay.
  • Will not institute legal action until making multiple attempts to reach and negotiate with patients before proceeding to legal action.

Post Judgment Practices.

Outside Counsel:

  • Will conduct judgment evaluations on a case-by-case basis. Electronic “blind” sweeps are not permitted and shall not be performed.
  • Will not cause an individual’s arrest or cause an individual to be subject to a writ of body attachment.
  • Will not renew a judgment against an individual without prior approval from the Hospital.
  • Will only institute legal action against an individual if the accounts are worth at least $800 in the aggregate or such other higher threshold as Hospital may from time to time set in writing if it is determined that an individual is able but unwilling to pay.
  • Consistent with the requirements of applicable law and this Policy, may Issue Information Subpoenas to the individual and to:
    1. Banks;
    2. Place of employment;
    3. Credit card companies; and/or
    4. Mortgage companies
  • Will not utilize a writ of capias (known as a “body attachment” in the popular press) as part of a collection effort.
  • Will suspend all collection activity against any judgment debtors that submit a completed application for financial assistance, seeking to be re-evaluated for financial assistance under HMH’s FAP, until the application has been adjudicated.

APPENDIX B: Providers by Department that Provide Emergency or other Medically Necessary Healthcare Services within the Hospital Facilities

Hackensack University Medical Center

Department/Entity/Group Covered by
Financial Assistance Policy
Anesthesiology NO
The Cancer Center NO
Dentistry NO
Emergency Medicine NO
Family Practice NO
Internal Medicine NO
Neurosurgery NO
Obstetrics and Gynecology NO
Ophthalmology NO
Orthopedic Surgery NO
Otolaryngology NO
Pathology NO
Pediatrics NO
Plastic & Reconstructive Surgery NO
Podiatry NO
Psychiatry and Behavioral Medicine NO
Radiation Oncology NO
Radiology NO
Rehabilitation Medicine NO
Urology NO
Hospitalists NO
Laboratory Services NO

Palisades Medical Center Updated 12/21/2018

Department/Entity/Group Covered by
Financial Assistance Policy
Anesthesiology NO
Emergency Medicine NO
Pathology NO
Radiology NO
Hospitalists NO
Intensivists NO
Cardiology NO
Department/Entity/Group Covered by Financial Assistance Policy
  JSUMC OMC RMC SOMC BMC RBMC OBMC
Anesthesiology YES YES YES YES YES YES YES
Dentistry NO NO NO NO NO NO NO
Emergency Medicine YES YES YES YES YES YES YES
Family Practice NO NO NO NO NO NO NO
Medicine NO NO NO NO NO NO NO
Obstetrics and Gynecology NO NO NO NO NO NO NO
Ophthalmology NO NO NO NO NO NO NO
Orthopedics NO NO NO NO NO NO NO
Pathology YES YES YES YES YES YES YES
Pediatrics NO NO NO NO NO NO NO
Psychiatry NO NO NO NO NO NO NO
Radiation NO NO NO NO NO NO NO
Oncology NO NO NO NO NO NO NO
Radiology YES YES YES YES YES YES YES
Surgery NO NO NO NO NO NO NO

JFK University Medical Center

Department/Entity/Group Covered by
Financial Assistance Policy
Allergy NO
Bariatric Surgery NO
Cardiology NO
Endocrinology NO
Gastroenterology NO
General Dentistry NO
GYN NO
Hematology/Oncology NO
Infectious Disease NO
Nephrology NO
Neurology NO
Neurosurgery NO
OB GYN NO
Opthalmology NO
Oral Surgery NO
Orthopedics NO
Otolaryngology NO
Pathology NO
Pediatric Orthopedics NO
Pediatric Surgery NO
Pediatrics NO
Physical Medicine and Rehab NO
Podiatry NO
Psychiatry NO
Pulmonary NO
Thoracic Surgery NO
Urology NO
Vascular Surgery NO

Members of this department do not follow the practices of Hospitals Financial Assistance Policy. Please contact their offices for confirmation of their participation. Members of Meridian Medical Group participate in Hospitals FAP and are members of the departments of Medicine, Oncology, Surgery, Obstetrics & Gynecology and Pediatrics.

A. View provider information on Hospitals Website

Website: An individual can view information about providers online at the following
www.hackensackmeridianhealth.org/en/Pay-Bill/Financial-Assistance/Financial-Assistance-Policy

B. Provider Listing An individual can obtain a paper copy of the provider listing by any of the following methods:

  1. By Mail: By writing to the following address and requesting a paper copy:
    • Carrier Clinic Behavioral Health Facility: 252 County Road Belle Mead, NJ 08502
    • Hackensack University Medical Center patients 100 First Street, Suite 300 Hackensack, NJ 07601
    • Palisades Medical Center, 7600 River Road, North Bergen, NJ, 07047
    • JFK University Medical Center, 65 James St, Edison NJ 08820
    • Hackensack Meridian JFK Johnson Rehabilitation Institute, 65 James St, Edison NJ 08820
    • Johnson Rehabilitation Institute At Ocean University Medical Center, 425 Jack Martin Boulevard, Brick, NJ 08724
    • Jersey Shore University Medical Center, Ocean Medical Center, Old Bridge Medical Center, Riverview Medical Center, Southern Ocean Medical Center, Bayshore Medical Center, and Raritan Bay Medical Center - 1945 Route 33, Neptune NJ, 07753

  2. In Person: By stopping by the Financial Assistance Department in person (Monday thru Friday, 8:00AM-4:00 PM), located at the following address:
    • Hackensack University Medical Center,100 First Street - Suite 300 Hackensack, NJ 07601
    • Palisades Medical Center, 7600 River Road, North Bergen, NJ, 07047
    • JFK University Medical Center, 65 James St, Edison NJ 08820
    • Hackensack Meridian JFK Johnson Rehabilitation Institute, 65 James St, Edison NJ 08820
    • Jersey Shore University Medical Center, 1945 Route 33, Neptune, NJ, 07753
    • Johnson Rehabilitation Institute At Ocean University Medical Center, 425 Jack Martin Boulevard, Brick, NJ 08724
    • Ocean Medical Center, 425 Jack Martin Boulevard, Brick, NJ 08724
    • Old Bridge Medical Center, One Hospital Plaza, Old Bridge, NJ 08857
    • Riverview Medical Center, 1 Riverview Plaza, Red Bank, NJ 07701
    • Southern Ocean Medical Center, 1140 Route 72 W, Manahawkin, NJ 08050
    • Bayshore Medical Center, 727 N Beers St, Holmdel, NJ 07733,
    • Meridian Family Health Center, 1828 W Lake Ave # 202, Neptune, NJ, 07753
    • Jane H Booker Family Health Center, Neptune, NJ, 07753
    • Booker Behavioral Health Center, Shrewsbury, NJ,
    • Behavioral Health Center, 61 Davis Ave, Neptune, NJ, 07753
    • Raritan Bay Medical Center, 530 New Brunswick Ave, Perth Amboy, NJ
    • Hackensack Meridian Health - Long Term Acute Care Hospital (LTACH) - 530 New Brunswick Avenue Perth Amboy, NJ 08861

  3. By Phone: The Financial Assistance Department can be reached at (551-996-3990) Carrier Clinic Behavioral Health Facility, 551 996-4343 Hackensack University Medical Center, 201-854-5092 Palisades Medical Center, or 732-902-7080 all other locations 

Revised 12/10/22

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