43,000 California patients could receive reimbursements and bill adjustments as part of discounted nursing billing

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On Monday, Healthcare in the Santa Clara Valley in California started notifying 43,000 patients on their entitlement to bill corrections and refunds.

The healthcare system includes a network of primary and specialist clinics, as well as three acute care hospitals – one of which: Santa Clara Valley Medical Center, is the largest public hospital in California. The system’s new patient education efforts are the result of a legal action filed a lawsuit against Santa Clara County in 2019 and settled in June.

The lawsuit was related to Santa Clara Valley Medical Center’s alleged failure to educate patients about its charitable programs. This is free or discounted care for low-income patients who are not eligible for third-party payer programs like Medicaid or Medicare. Three former patients of the hospital filed complaints, alleging that the county failed to inform them about the hospital’s charitable policies while they were hospitalized or after they were discharged. This resulted in them being sent to collect between 2013 and 2017 for bills ranging from $8,000 to $35,000, the lawsuit says.

At the time of her hospitalization, one of the plaintiffs was an uninsured single mother of two. Another was uninsured and spoke mainly Spanish, and the third patient was homeless.

As part of the dispute resolution, Santa Clara County will send notices to patients whose bills were sent to collection agencies between October 28, 2018 and December 31, 2021 to inform them that their bills will be re-examined for full or partial discounts can be or refund claim.

Patients who receive this letter have 65 days to return a form confirming their interest in requesting a bill correction. After that, they have another 150 days to complete their application, including submitting documents and verifying personal information.

With the settlement of the lawsuit, Santa Clara County also pledged to implement better policies at its hospitals to ensure patients are aware of its charitable programs and how to apply for discounted treatment, the county said in a statement. To begin implementing this change, the county will begin sending out informational communications to all of its patients who may be eligible for charity treatment.

In the future, notifications will be given to patients during their stay in hospital or sent by post within a few days of their discharge. The information sheets, which will be available in eight languages, inform patients how they can qualify for free or discounted treatment.

In addition, the notices inform patients that the county can help them with payment assistance forms and applications for government-sponsored health plans such as Medi-Cal. The notices also tell patients that they can apply for financial assistance at any time during the collection process.

“These newly implemented outreach efforts, combined with our current programs, multilingual approaches and recent government-initiated efforts, will allow us to better serve those most in need,” Paul Lorenz, CEO of Santa Clara Valley Healthcare, said in a statement.

California requires all acute care hospitals to provide charitable care. In 2020, the Santa Clara County Board of Directors approved a program that provides free care to hospital patients whose annual household income is at or below 400% of the state poverty line, and also offers significantly reduced payments for those whose income is between 401% and 650% . the poverty line.

Photo: fizkes, Getty Images

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