WINNSBORO — The Fairfield Memorial Hospital recently made a presentation to Fairfield County Council to inform council and the community about potential changes in the organization’s collection policies.

The presentation was made as a courtesy since policy changes could affect members’ constituents. Any policy changes, however, will come from the hospital board, not county council.

Tim Mitchell, CFO for Fairfield Memorial, said FMH is attempting to tighten up its collection policies in three areas. One focal area is emergency department care. Mitchell specifically said the hospital will continue to provide emergency care to anyone presenting an emergency medical situation regardless of the person’s ability to pay.

Patients entering the emergency department with a situation that is triaged as an emergency must be treated by law without payment being accepted up front.

Mitchell said one problem area for FMH was in its procedure for asking other persons treated in the ER to pay for services. Under the proposed changes, a patient triaged by a nurse and determined not to have an emergency condition will be required to pay for services rendered. Mitchell said that as part of the bedside registration process, the hospital will ask for payment at that time.

Another proposed change is to FMH’s charity care policy. Currently the hospital has a policy that is income based. A patient’s percentage of being over the poverty line could entitle them to a 100 percent reduction or to a partial discount on his or her bill.

However, total assets have not been involved in the equation. So, hypothetically, someone who is unemployed could meet the income requirements under the current system and receive the entitlement when he or she in fact had enough funds in a bank account to pay the bills.

“The (hypothetical) circumstance would be unfair because it is giving an entitlement to folks with the ability to pay,” Mitchell said.

The proposed change would require income and asset tests to be used when determining need, which Mitchell said is similar to procedures used by other hospitals in South Carolina.

The third area being addressed is the collections process. Currently debt for both inpatient and outpatient clients is set off through the S.C. Department of Revenue where the hospital secures payments against the patient’s tax refund. FMH is considering expanding its process to include the GEAR program which would allow the hospital to garnish wages of persons who have means to pay their bills but are not doing so.

A concern of county council was of the system taking an existing case of financial hardship and making it worse. Mitchell said that GEAR (Governmental Enterprise Accounts Receivable) Collections is sensitive to financial hardship and that safeguards are in place with specific options to make sure persons in clear positions of financial hardship do not have wages garnished.

“With more and more folks who are under-insured or uninsured seeking services, it adds pressure to provide services without the reimbursements to FMH. So it is more critical than ever to collect payment from those who can afford to pay,” Mitchell said.

Mitchell and other hospital staff will bring these points to the hospital board for its January meeting. At that time there will be more discussion about future policies. After the hospital board of trustees has a final vote on the matter then some, or all, of the policies outlined here might be implemented.