MEDICAL DEBT ASSISTANCE

What is medical debt? 

It is past due medical bills from diagnosing, treating or preventing an illness or a physical or mental disability.  The most common forms of medical debt come from:

  • Doctors, surgeons, dentists, and other medical professionals (eye doctor, therapists, etc.) visits;
  • Hospital visits, outpatient surgeries and overnight stays;
  • Lab tests;
  • Medical devices, equipment and supplies;
  • Prescription drugs,
  • Specialized Transportation (for example, by ambulance).

It is one of the worst kinds of debt because it is not your fault.  An unexpected illness or an accident can result in medical debt even if you have health insurance.  For this reason, medical debt is treated differently than other types of debt on your credit report.  To learn more, see “What to Do I You Have Medical Debt” from the menu on the left.

If you have medical debt, you are not alone. 

Here are some facts about medical debt in Tennessee:

  • 1 in 5 Tennesseans have medical debt on their credit report.
  • Tennessee has the 8th highest rate of medical debt in the United States.
  • Most Tennesseans with medical debt have less than $1,000 on their credit report.

How to avoid medical debt.

Having health insurance is the key.

  • You may qualify for public health benefits like TennCare, CoverKids or Medicare Savings Programs;  OR
  • You may qualify for government help buying private health insurance. 
  • To learn more, click here.

Use the menu on the left to learn more about medical debt.  To talk to us about your experience with medical debt, click here.

Note: All bolded + italicized words are defined in our glossary of terms on the left of this page.

Are you sure you owe that medical bill?

Healthcare providers and insurance companies are run by people, and people are prone to make mistakes.  This happens more often than you think because medical billing and coding are complex tasks.

  • Medical coding takes a doctor’s diagnosis and links it to the appropriate code. For every injury, diagnosis, and medical procedure, there is a corresponding code.
  • Medical billing takes the information from the medical code and makes a bill.
    • If the bill is sent to an insurance company, it is called a called a claim.

Start by getting organized… 

Take a close look at your medical bill.  If you don’t understand it, call your healthcare provider and ask them to explain it to you.  Here are some questions to ask:

  • Does the medical billing and coding sound like the care or treatment that you received?
  • If not, should it have been coded and billed differently?
  • If coded and billed differently, would health insurance cover the bill?
  • If insurance does cover the bill, what is the balance (if any) that you will owe?

If you have private health insurance…

  • Compare the bill with the Explanation of Benefits (EOB) statement from your insurance company.  The EOB is not a bill.
    • The EOB provides details about your insurance claim:
      • How much was paid by the insurance company to the healthcare provider; and
      • How much (if any) you owe the healthcare provider.
      • Any portion of the medical expense not covered by the insurance company, such as a deductible or a co-pay, is owed to the provider.
  • If you don’t understand why you owe money; or you are having trouble reading the EOB, call your insurance company and ask them to explain it to you.
  • Generally, the healthcare provider will send you a bill for the amount not covered by your insurance.
    • Usually, this bill comes after the healthcare providers knows how much your insurance company will pay.
    • Payment should be paid directly to the provider – not your insurance company.

If you have TennCare

  • TennCare should cover medically necessary treatment or medication prescribed by your doctor.  What is “medically necessary” can be complicated. 
    • If TennCare won’t pay for a treatment or medicine prescribed by your doctor, we may be able to help.  Just fill out our “TJC Intake” form by clicking here.
    • Usually, a payment by TennCare to a provider is considered payment in full for the care you received. 
      • This means a healthcare provider cannot bill you for the portion of the bill that TennCare didn’t pay.  This is called, “Balance Billing”. 
      • If your healthcare provider incorrectly billed you for the balance of the bill that TennCare didn’t pay, we may be able to help.  Just fill out our “TJC Intake” form by clicking here.

If you have CoverKids

  • CoverKids is available to pregnant women and children under the age of 19.  CoverKids typically pays for:
    • Preventive healthcare which is free. 
    • Hospital stays, sick visits and medication that have very slow copays. 
    • Children under 19 also get dental and vision benefits.
    • Pregnant women get prenatal, delivery and 60 days postpartum care.
  • What is “medically necessary” can be complicated. 
    • If CoverKids won’t pay for a treatment or medicine prescribed by your doctor, we may be able to help.  Just fill out our “TJC Intake” form by clicking here.

If you have Medicare

  • Unfortunately, Medicare does NOT pay for everything.  Medicare coverage for many tests, items, and services may depend on whether you have original Medicare, an advantage plan or a PPO.
    • To find out if your test, item, or service is covered, click here.
    • For help with Medicare questions, contact the State Health Insurance Program (SHIP).  SHIP is a national program that provides free and objective one-on-one counseling, information and help to people with Medicare, people who may need Medicare, and people looking into Medicare for someone else.
      • For more information about SHIP, call 1-877-801-0044.
  • If you need help paying your out-of-pocket Medicare costs, you may qualify for a Medicare Savings Program.  We can help you find out if you qualify.  Just fill out our “TJC Intake” form by clicking here.

If this information helped you fix a problem with medical debt, we want to hear from you.  Please take a few minutes and tell us about it.  We would like to know your story!

  • To tell us about your medical debt, click here.

If you still have medical debt, go to “What To Do If You Have Medical Debt” for more options.

Note: All bolded + italicized words are defined in our glossary of terms on the left of this page.

Believe it or not, it is possible to get your medical debt reduced to a manageable amount or even reduced to $0.  These 5 Tips can help you to get started.  

Tip 1  Seek help immediately 

  • If your debt is from a hospital, you may qualify for help under the hospital’s financial assistance policy.  It is called “charity care” or “medical indigence”.  If you qualify, hospitals may reduce your bill considerably (for example 70%) or even for forgive it entirely.   
    • To learn more, click on “Hospital Charity Care” from the menu on the left. 
    • Also read Tip 2 below about negotiating with a hospital. 
  • When you received your care, did anyone help you apply for TennCare or CoverKids?  If so, did you get a decision about your eligibility?   
    • Wmay be able to help if: 
      • You applied and never got a decision on your eligibility. 
      • You were denied, but you think you are eligible. 
      • Your coverage start date is wrong.   
      • Just fill out our “Request Help” form by clicking here. 

Tip 2  Negotiate the amount that you owe 

There is nothing wrong with trying to negotiate a lower price for the care that you received from your healthcare provider – even after you received the care.  This may not be easy to do, but it is worth trying!  

  • If your debt is from another healthcare provider besides a hospital, try to negotiate your bill lower.   
    • It is important to remember to communicate with the healthcare provider and ask for discounts and any financial assistance that may be available.   
    • Healthcare providers may not automatically apply discounts to your bill or inform you about available financial assistance.  You need to ask. 
    • Discuss what you can afford to pay and over what period of time.  This may prevent them from sending your account to a debt collection company. 
  • If your debt is from a hospital AND you don’t qualify for financial assistance, ask for a discount. 
    • You may be told that price you are being charged for a medical procedure is based on the hospital’s “chargemaster” or charge description master (CDM).   
    • Chargemaster defined – it is a listing of items prices for services, procedures, equipment fees, drugs and supplies including diagnostic evaluations.  It covers everything a hospital can charge.  Items on the chargemaster as also assigned a billing code along with a price that is used to generate your bill. 
      • It contains highly inflated prices sometimes several times the actual cost to the hospital.  It is used by hospitals to negotiate actual price health insurance companies will pay for the service. 
      • Typically, it isn’t made available to the public. However, some states are considering legislation that would make hospitals disclose their chargemaster to the state to be published online for the public.  
    • If you are being charged the chargemaster price, ask what MedicareTennCare and private insurance pays for the same service.   
    • Find out if the price you were charged was reasonable.  Use these sources to compare prices: 
      • Healthcare Bluebook – click here. 
      • Fair Health Consumer – click here. 

Tip 3  Don’t pay medical debt with a credit card… 

  • When you pay with a credit card, you turn medical debt into credit card debt.  This is important for several reasons: 
    • Paying by a credit card means the healthcare provider has been paid so there is no incentive for the healthcare provider to negotiate your bill lower 
    • Credit card companies charge late fees and usually charge higher interest rates Healthcare providers usually don’t charge late fees and have a low interest rates. 
    • You are less likely to be sued on medical debt than credit card debt. 
    • Credit card debt and medical debt are NOT treated the same by credit reporting agencies.   
      • Past due credit card bills affect your credit score immediately, medical debt takes 6 months to show up on your credit report. 
  • Avoid using “medical” credit cards because unpaid balances will be treated as credit card debt – not medical debt. 

Tip 4  Medical debt is not treated like other types of debt… 

Generally, healthcare providers don’t report your unpaid medical bills to a credit reporting agency or credit bureau.  Instead, they refer past due accounts to a debt collection company.  These companies may decide to report your debt to the credit bureaus.  Here is what you need to know. 

  • Federal law stops credit bureaus from putting medical debt on your credit report until it is past due for 6 months.  This gives you time to dispute the bill or negotiate a lower price with your healthcare provider. 
  • After 7 years, medical debt is removed from your credit report. 
  • Once your medical debt is paid, it is removed from your credit report. 
  • According to IRS rules, non-profit hospitals must make reasonable efforts to determine if you are eligible for charity care before reporting our debt to the credit bureaus.  To be safe, it is great to ask if you qualify for financial assistance or charity care. 
    • You usually have 8 months from when you first received the bill to request financial assistance. 
    • To learn more, click on “Hospital Charity Care” from the menu on the left. 

Tip 5 – Medical Debt is not as urgent for you to pay as your necessary living expenses. 

Keeping a roof over your head, heat in your home, food on the table and transportation to work are very important.  You should pay these bills first before paying off your medical debt.  This does NOT mean ignoring your medical debt.  Instead, be smart with the income that you have.  

  • Remember, asking for help as soon as possible and talking to your healthcare provider about financial situation is very important.  Your efforts may slow the collection process, and even reduce the amount that you owe.  (see Tip 1 Above) 
  • Failing to pay your rent/mortgage, utilities or your car loan may lead to eviction, foreclosure, termination of services and/or repossession of your car. The consequences for not paying these bills may be more severe. 
  • Unlike medical debt, other types of debt can immediately hurt your credit report.  This is not true with medical debt. 

Note: All bolded + italicized words are defined in our glossary of terms on the left of this page.

What is Charity Care? Tennessee law defines charity care as…

Charity care is defined as reductions in charges made by the provider of services because of the indigence or medical indigence of the patient. Tenn. Code Ann. § 68-1-109(2)

  • “Medical indigence” is defined as “a status reached when a person uses or commits all available current and expected resources to pay for medical bills and is not limited to a defined percent of the Federal Poverty Guidelines.” Tenn. Code Ann. § 68-1-109(2)(A)(ii)
  • The provider should apply the following guidelines for making a determination of medical indigence:
    • The provider should take into account a patient’s total resources, which include, but are not limited to, an analysis of assets, only those convertible to cash and unnecessary for the patient’s daily living, liabilities, and income and expenses.  Tenn. Code Ann. § 68-1-109(2)(A)(ii).
    • In making this analysis, the provider should take into account any extenuating circumstances that would affect the determination of the patient’s indigence.  Tenn. Code Ann. § 68-1-109(2)(A)(ii).

In plain language… 

Charity care is free or discounted medical care that is given by hospitals to people who can’t afford to pay.  Who qualifies will be based on things like: sources of income, any assets that patients have and what types insurance patients have.

The good news about charity care…

  • It includes inpatient and emergency room services.
  • Hospitals must publish their financial assistance policy AND follow it when making charity care eligibility decisions.
  • Even if you have health insurance, you may still qualify for charity care for the part of your hospital bill that insurance didn’t pay.
  • Under the Affordable Care Act (ACA), non-profit hospitals must offer charity care to keep their non-profit status with the IRS.
  • Some for-profit hospitals may offer financial help based on your ability to pay.
    • ALWAYS ask if the hospital offers financial assistance or charity care for its patients.
      • If YES, ask for a copy of the policy.  Also, ask to speak with someone who can help you apply for it.
      • If NO, ask to speak with someone about your bill using the tips found in “What To Do If You Have Medical Debt” from the menu on the left.

The not-so good news about charity care…

  • It varies depending on the hospital you visit.  This includes:
    • How the application process works
    • The eligibility requirements
    • The amount of the financial assistance available
    • Hospitals do not have to automatically screen you for eligibility.
    • Hospitals are only required to post their charity care policies in a place accessible to the public. Some hospitals do a better job of informing patients than others.
    • It is not defined by a specific percentage of the Federal Poverty Guidelines.

How charity care is funded…

Hospitals pay certain licensing fees to operate in Tennessee.  These fees are deposited in the Indigent Health Care Risk Fund that is overseen by the Commissioner of Finance and Administration.  These funds are distributed to hospitals to help offset the costs of treating patients who cannot afford to pay.

The penalties for hospitals that do not comply…

Hospitals have specific reporting requirements to receive money from the Indigent Health Care Risk Fund.  Hospitals who fail to file the report are given 15 days to submit a plan to correct the problem or provide missing information.  Hospitals that fail to report are subject to disciplinary action. 

Non-profit hospitals that fail to comply with IRS billing and collection rules (Section 501(r)) can lose their tax exemptions.

How to apply for charity care…

You need to follow the hospital’s directions when applying for charity care. 

  • If you were denied, but your financial situation has changed, update your application or reapply.
  • Having been denied charity care in the past doesn’t necessarily mean you will be denied in the future. 
    • Your financial situation may have changed;
    • The FPL may have increased;
    • The hospital’s charity care policy may have changed in your favor.
    • Typically, you have 8 months from the date you received the bill to ask for charity care.

What you will need to apply for charity care…

Hospital applications will vary depending on the hospital.  Generally, you will need to provide the following information:

  • Names, ages and the relationship of your household members to the patient applying for charity care.
    • Whether they are your legal dependents.
    • Employment status of household members.
    • Total household monthly gross income
      • Gross income is before taxes and any other money that is withheld from your check.
      • Proof of income for your household – paystubs, tax returns, Social Security Administration statement of benefits, food stamp approval letter, unemployment approval letter or other proof of government assistance.
      • Income from other sources – investments, rental property, unemployment, alimony received, child support, etc.
      • Proof of residency – government issued documents containing your current address like your driver’s license, rental agreement or utility bill.
      • Health insurance status of your family members
        • Members covered by insurance
        • Past insurance coverage (year or 6 months)
        • Members has an offer of insurance coverage from their employer
        • Past applications for public health benefits – TennCare, CoverKids, Social Security benefits, private disability benefits, etc.
        • Assets and Resources
        • Bank and checking accounts
        • 2nd home or rental property
        • Vehicles
        • Recreation vehicles- boat, camper, motorcycles, etc.
        • Retirement accounts
        • Monthly expenses
          • Rent/Mortgage
          • Home owners/renter’s insurance
          • Utilities
          • Alimony paid
          • Child support paid
          • Loans
          • Food
          • Medication

When you apply, ask the hospital what documents you need to provide to support your application for charity care.  For example, do you need to provide a copy of your latest tax return or paystubs to prove your income. They will be able to tell you. 

Can a hospital turn me away for failing to pay my medical debt?

Here are a few things to know:

  • Under the Emergency Medical Treatment and Active Labor Act (EMTALA), a hospital CANNOT refuse to treat you in their emergency department.
  • In certain situations, hospital may decide to stop providing services to you for unpaid medical debt owed to them.
  • If you have requested charity care from a non-profit hospital, the hospital CANNOT deny you care until a decision has been reached a decision on your charity care application.
  • Owing money to a different hospital(s) should not prevent you from receiving services from other healthcare providers.

For help with debt collection companies, click on “How To Deal With Debt Collectors” from the menu on the left.

Note: All bolded + italicized words are defined in our glossary of terms on the left of this page.

In General…

Both the debtor collection company and the person acting on behalf of the company must be licensed in the state Tennessee. 

The statute of limitations to file a lawsuit for the collection of medical debt is 6 years.  Keep in mind, the statute of limitations is only a defense when someone is suing you.  It does NOT eliminate your medical debt or prevent a debt collector from trying to collect from you.  If debt collector is trying to get you to pay a debt older than 6 years, mention the defense of the statute of limitations.  This might deter them from further collection efforts.

  • After 7 years medical debt is removed from your credit report. To learn more, click on “What To Do If You Have Medical Debt” from the menu on the left.

TIP: – research the debt collection company that is calling.  Is the caller from a legitimate business or is it a scam?  Ask the person calling you to provide their name, company, phone number and business address.  If they don’t want to provide you with that information, it may be a scam.  Read on to learn what debt collectors can and cannot do so you are prepared.

Communication – What debt collectors CANNOT do…

Unless you give the debt collectors permission, they may not communicate with you about your debt:

  • At any unusual or inconvenient time or place.
    • Unless you tell them otherwise, it is presumed they can call you between 8:00 a.m. and before 9:00 p.m., local time.
    • Unless you tell them otherwise, they can call you:
      • at home.
      • at work unless they know your employer does not allow it.
  • If you are represented by an attorney for your medical debt, they must converse with your attorney.
  • Call you at work if they know that your employer does not allow it.  You can tell them by phone or in writing.

TIP: Always keep a record of anything discussed during a call with a debt collector.  This includes the person’s name, date and time.  Always keep copies of letters that you receive or send to a debt collector.  Send all letters certified mail with return receipt requested whenever possible.  If you faxed documents, keep the fax receipt with the documents you sent.

Communication with other people…

Debt collectors cannot discuss your debt with anyone other than you, your attorney or a consumer credit reporting agency without your permission (unless otherwise permitted by law).

TIP:  To stop unwanted calls and letters…

  • You can send a “cease” letter to the debt collector telling them:
    • To only contact you during certain hours and/or at a certain number. 
    • Not to call you at work.
    • Not to call you at all about your medical debt. 
  • The debt collector must stop contacting you, except to tell you:
    • They are no longer pursuing you for payment.
    • They may use a specified remedy like filing a lawsuit against you;
    • They intend to use a specified remedy.
  • This just stops the debt collectors from contacting you.  It doesn’t get rid of your debt. 
  • You can download a copy of this letter here.

Debt collectors CANNOT harass you…

They cannot harass or abuse you or others when trying to collect a debt.  The following is considered harassment under Tennessee law:

  • The use or threat of violence against you or to harm your reputation, or the property of any person.
  • The use of obscene or profane language while speaking with you
  • Publish a list of consumers who allegedly refuse to pay debts, except to a consumer reporting agency.
  • Advertising for sale your debt to get you to pay.
  • Constantly calling you with intent to annoy, abuse, or harass any person at the dialed number.
  • Calling without disclosing their identity.

Debt Collectors CANNOT use false, deceptive or misleading representation…

The following conduct is considered to false, deceptive or misleading:

  • Implying debt collector is vouched for, bonded by, or affiliated with the United States or State of Tennessee, including the use of any badge, uniform, or facsimile thereof.
  • Falsely representing the type, amount, or legal status of any debt;
  • Falsely saying that any individual is an attorney or that any communication is from an attorney.
  • Saying or implying that failure to pay will result in your arrest or criminally prosecute you.
  • Saying or implying failure to pay will lead to the taking and sale of your property or garnishment of your wages unless such action is lawful and the debt collector intends to take such action.
  • Threaten to take any action that they cannot legally do.
  • Falsely saying or implying that a sale, referral, or other transfer of your debt will cause you to lose a defense to payment of the debt.
  • Falsely saying or implying you committed a crime in an effort to disgrace you.
  • Providing or threatening to provide your credit information to others that is known to be false.
  • Failure to communicate to a credit reporting agency that you are disputing the debt.
  • Sending false information that appears to be a document authorized, issued, or approved by any court, official, or agency of the United States or State of Tennessee.
  • The use of any false representation or deceptive means to collect a debt or to obtain information about you.
  • The failure to disclose in the initial communication with you that the debt collector is attempting to collect a debt; and any information obtained will be used for that purpose.
  • Falsely saying or implying your accounts have been turned over to innocent purchasers for value.
  • Falsely stating or implying that documents are legal process.
  • The use of any business, company, or organization name other than the registered name of the debt collector.
  • Falsely saying or implying that they operate or are employed by a consumer reporting agency.

Debt collectors CANNOT use unfair tactics to collect a debt…

The following conduct is a considered an unfair collection practice:

  • The collection of any amount including any interest, fee, charge, or other expense unless you expressly agreed to it when creating the debt or is permitted by law.
  • Asking for a postdated check or other postdated payment for the purpose of threatening or instituting criminal prosecution.
  • Depositing or threatening to deposit any postdated check or other postdated payment prior to the date on such check or instrument.
  • Communicating with you about your debt by post card.

Debt collector MUST validate your debt…

Unless provided in the initial communication, the debt collector must send you a written notice that contains the following information:

  • The amount of the debt;
  • The name of the creditor to whom the debt is owed;
  • A statement that you have 30 days to dispute whether you owe the debt.  If you don’t, the debt will be assumed to be yours and valid for the debt collector to pursue payment;
  • A statement that if you notify them in writing within the 30-day period that you are disputing the debt owed, the verification of the debt will be mailed to you by the debt collector; and
  • A statement that if you notify them in writing within the 30-day period, they will provide you with the name and address of the original creditor.

If you dispute the debt within the 30-day period, the debt collect must stop collection efforts until verification of the debt is mailed to you.

TIP: If information is missing from the debt collector’s verification letter, write and ask them for the information. For example, ask for the name and address of the original creditor that you allegedly owe the debt.  If it has been longer than 30 days, still send the verification request.  The debt collector may respond to your request even though they don’t have to.

TIP:  If you don’t believe that you owe the debt, send a dispute letter right away.  This should stop their collection efforts until they determine if you owe the debt and send you information proving that it is yours. 

If you are living on government benefits only…

You may be able to stop the debt collector from taking further action to collect your medical debt.  It is sometimes referred to as being “judgment proof”.  This means that even if the debt collector wins in court, they will not be able to collect the money from you.  Most governmental benefits like Social Security benefits, Social Security Disability Insurance payment and Supplement Security Income (SSI) are not subject to garnishment for medical debt. 

TIP: Tell the debt collector you live solely on governmental benefits.  We recommend sending them a letter indicating you believe your income is exempt from garnishment. 

You can file a complaint against a debt collector…

TIP: If you believe the debt collector is harassing or using unfair collection practices against you, you can file a complaint with the Consumer Financial Protection Bureau by clicking here.  A copy of your complaint will be sent to the debt collector for them to respond.  Generally, you will receive a response within a couple of weeks.

  1. Affordable Care Act aka Obama Care – The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”). The law has 3 primary goals:
    1. Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
    2. Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
    3. Support innovative medical care delivery methods designed to lower the costs of health care generally.
  2. Alimony – financial support that a person is ordered by a court to give to their spouse during separation or following divorce.
  3. Balance Billing – When a provider bills you for the difference between the provider’s charge and the allowed amount.  Whether balance billing is legal depends on the type of insurance.
  4. Chargemaster or Charge Description Master – it is a listing of items prices for services, procedures, equipment fees, drugs and supplies including diagnostic evaluations. 
  5. Charity Care – is free care or discounted care given to hospital patients who are unable to pay based on established financial assistance policies by the treating hospital.
  6. Co-pay – A fixed amount (for example, $20) you pay for a covered health care service after you’ve paid your deductible (if you have one).
  7. Credit report or Consumer Report or Credit Record – is the information about a consumer that a credit bureau has on file that it can report to others.  The report includes the credit history and current status of a consumer’s monthly payment obligations and public information such as bankruptcies, court judgments, and tax liens.
  8. Credit Reporting Agency or Credit Bureau – a business that maintains historical credit information on individuals and businesses. They receive reports from lenders and various other sources which are compiled in a credit report that includes a credit score when issued.  The 3 majors are Experian, TransUnion and Equifax)
  9. Creditor – any person or business to whom you owe money
  10. Debt Collection Company or Debt Collector – The most common use of this term applies to anyone who collects debts.  However, under the federal Fair Debt Collection Practices Act or “FDCPA,” the term “debt collector” only applies to collection agencies and lawyers (or their employees) that are collecting debts for others.  In Tennessee, debt collectors must be licensed.
  11. Deductible – The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.
  12. Dependent – someone who is sustained by another person, such as a child supported by his or her parents.
  13. Disability Benefits – is a type of insurance product that provides income in the event that a policyholder is prevented from working and earning an income due to a disability
  14. Explanation of Benefits (EOB) – The EOB provides details about a medical insurance claim that has been processed and explains what portion was paid to the health care provider and what portion of the payment, if any, the patient must pay.
  15. Federal Poverty Guidelines or Federal Poverty Levels (FPL) – is a measure of income used by the U.S. government to determine who is eligible for subsidies, programs, and benefits. The Department of Health and Human Services updates the poverty guidelines each January 1st. It raises the FPL to account for inflation.
  16. Financial Assistance Policy – Medically necessary hospital health care rendered to indigent persons when:
    1. health insurance coverage, if any, has been exhausted.
    2. the patient is unable to pay for the care or to pay deductible or coinsurance amounts required by the insurance company.
    3. The patient does not have the financial recourses to otherwise pay for their care.
  17. For-Profit Hospital – a hospital owned either by investors or the shareholders of a publicly-traded company.
  18. Garnishment – A creditor’s seizure, to satisfy a debt, of property belonging to the debtor that is in the possession of a someone else.  Usually, your wages are the target of a garnishment order.
  19. Gross Income – is the sum of all wages, salaries, profits, interest payments, rents, and other forms of earnings, before any deductions or taxes.
  20. Medicaid – Insurance program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities.  It is called TennCare in Tennessee.
  21. Medical Billing – translates a healthcare service or medical code into an insurance billing claim. 
  22. Medical Coding – the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician’s notes, laboratory and radiologic results, etc.
  23. Medical Indigence – when a person lacks the financial ability to pay for their care.
  24. Medicare – A federal health insurance program for people 65 and older and certain younger people with disabilities. It also covers people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
  25. Non-profit Hospital – A hospital that is exempt from paying income and property taxes. In such a facility, funds earned are reinvested in the hospital and its services instead of being paid as dividends to shareholders.
  26. Retirement Account – a plan for setting aside money to be spent after retirement.  Popular types include: pension account, pension plan, retirement plan, retirement program, retirement savings account, retirement savings plan (not an exhaustive list)
  27. Social Security Benefits – payments made to qualified retirees and disabled people, and to their spouses, children, and survivors.
  28. TennCare – the name of Tennessee’s Medicaid program.

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