In compliance with section 501(r)(4) of the Internal Revenue Service, the hospital will inform their patient(s)/guarantor(s) of the financial assistance policy and will make reasonable efforts to determine eligibility for financial assistance. The patient(s)/guarantor(s) will be notified in writing of the determination. If the determination is made that an individual is eligible for assistance the hospital will reverse, when possible, adverse results of any collection efforts and will refund any over-paid amounts to the individual. The hospital will also issue a new billing statement that indicates the amount owed and shows or describes how the patient can obtain information regarding the amounts generally billed (AGB) for the care and how the facility determined the amount that the individual owes.
For patients who do not qualify for financial assistance, a prompt pay discount may be available.
Covered and Non-Covered Providers
All Trego County Lemke Memorial Hospital employees are covered by this policy.
Entities and Providers Not Covered by this Policy: Physicians or medical professionals provide care to patients or assist with patient treatment by reading lab work, interpreting medical tests, performing medical tests and individual patient physician services. The physicians and medical professionals not employed by Trego County Lemke Memorial Hospital are not covered by this policy.
An application for financial assistance can be initiated by a patient or guarantor in person at the business office; over the phone by calling 785-743-2182; through the mail at Trego County Lemke Memorial Hospital, 312 N 13th St, WaKeeney, KS, 67672, or at the TCLMH website www.tclmh.org.
The completed application, along with the supporting documents listed on the application, may be sent to Trego County Lemke Memorial Hospital at 320 N 13th Street, WaKeeney, KS 67672, or it may be delivered to the business office.
After the application for Financial Assistance has been completed, account(s) being considered for Financial Assistance will be put in a “hold” status while the application is being reviewed (no longer than 30 days). The hold status will prevent account(s) from proceeding through the collection process, including assignment to a collection agency. Once the Financial Assistance application has been processed and approved or denied, the Hospital will send written notice to the patient/guarantor.
Financial Assistance is secondary to all other financial resources available to the patient, including employer-based insurance coverage, commercial insurance, government programs, third party liability and household qualified assets. The approved financial assistance is only applied to the self-pay portion of a patient's bill.
The Financial Assistance Program (FAP) employs a sliding scale discount that takes into consideration a patient’s household income. The patient’s Household income must be less than 300% of the Federal Poverty Level (FPL) to qualify for financial assistance discount.
For additional information on financial assistance or to ask questions, inquirers may call Trego County Lemke Memorial Hospital at 785-743-2182 or visit in person at the business office at 320 N 13th St, WaKeeney, KS.
If you feel you may qualify for financial assistance, or if you have any questions, please contact the business office at 785-743-2182.