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Home » Financial Assistance at Amberwell Hiawatha

Financial Assistance at Amberwell Hiawatha

AMBERWELL HEALTH GUIDELINES FOR FINANCIAL ASSISTANCE

Amberwell Health provides care to patients in our service area without regard to their ability to pay for the services. Realizing that many in our service area need special consideration in this regard, Amberwell Health provides a significant amount of services at no charge or a reduced cost to eligible persons who are indigent and cannot pay for care.  Discounts for qualified patients are based on a percentage of the Federal Poverty Guidelines.  These guidelines are updated annually.  Patients may apply at the time of service, or up to 240 days after receiving their first statement.  Before applying the discount, the total charges will first be reduced by the average percentage of write off for all payer contracts. 

Persons and services NOT eligible:

  • Non-U.S. citizens, lacking immigrant status (including visitors and students).
  • Persons who reside outside of Amberwell Health service area at the time of service based on location.
  • Elective/non-emergent procedures including but not limited to: cosmetic type of services, fertility and infertility treatment and procedure including birth control, circumcision, hearing aids and evaluations, weight loss programs unless diabetes related, sports physicals, and Lap Band procedures.
  • Persons not cooperating to obtain eligibility or payment assistance from third party resources.        
  • Collection agency accounts that have incurred legal fees.

Eligibility guidelines:

Eligibility is based on residency, gross income, and household size. The discount is given only after all payment sources have been exhausted.

  1. Residency:
    • Applicant must be a permanent resident of Atchison Hospital’s service area.  A post office box is not acceptable. A utility bill or another form of mail addressed to the applicant at the permanent residence will be required.
      • Primary service area in Kansas:  Atchison, Bendena, Cummings, Denton, Easton, Effingham, Everest, Horton, Lancaster, Leavenworth, Muscotah, Nortonville, Potter, Troy, Winchester, and Valley Falls.
      • Primary service area in Missouri: Rushville.
    • If a person is an immigrant, applicant must have an “Alien Resident Card” or a “United States Citizen Identification Card”, not a temporary card or pending status.
  1. Income:
    • All applicants will be asked to disclose and document all sources of income received by the household.
    • Patient or family must have written verification of household income for three or twelve months
  1. Household:
    • A household is a group of people who live together. They must be connected by marriage, civil partnership, or be a recognized couple (same sex or opposite sex), or they can be related – a child, parent, sister, brother, nephew, niece, or in-law, for instance – or have another recognized connection such as fostering or adoption. A household is all people living together in one house collectively.

To inquire about financial assistance please call Amberwell Health’s Financial Counselor at (913) 360-5533. You may obtain Financial Assistance information and an application at our Financial Counselor, hospital outpatient registration, & Emergency Department registration areas. You may also find our Financial Assistance application and guidelines online at www.amberwellhealth.org. Financial Assistance signs are also posted at hospital outpatient & ED registration desks. Financial Assistance notification is also included on the patient statements and letters.

Financial assistance may be applied on any account(s) that have been assigned to an outside collection agency.  Amberwell Health can place accounts with a collection agency within 120 days, however, the collection agency cannot begin any extraordinary collection actions before the first 240 days from the date of the first statement.

  • Financial Assistance Print Application
  • Financial Assistance – Plain Language Summary
  • Financial Assistance Policy

Definition of Household

A household is a group of people who live together. They must be connected by marriage, civil partnership, or be a recognized couple (same sex or opposite sex), or they can be related – a child, parent, sister, brother, nephew, niece, or in-law, for instance – or have another recognized connection such as fostering or adoption. A household is all people living together in one house collectively.  The poverty guidelines are applied to the household as a whole and not the individual.

Definition of Income

Income is the total annual cash receipts before taxes from all sources, for all persons in the family unit, with the exceptions noted.  Income data for a part of a year may be annualized to determine eligibility – for instance, by multiplying four the amounts of income received during the most recent three months.  Income includes money, wages (including overtime), and salaries before any deductions.  Income also includes gross receipts from non-far or farm self-employment.  Income includes (but not limited to) regular payment from social security, railroad retirement, unemployment, compensation, strike benefits from union funds, workers’ compensation, veterans’ payments, public assistance.

Supplemental Security Income, General Assistance or General relief money payments, training stipends, alimony, child support and military family allotments or other regular support from an absent family member or someone not living in the household; private pensions, stocks, bonds, government employee pension (including military retirement pay) and regular insurance or annuity payments; college or university scholarships, grants, fellowships, and assistantships; and dividend, interest, net rural income, net royalties, receipts from estates or trusts, inheritance and net gambling or lottery winnings.

Presumptive Eligibility

There are instances when a patient may appear eligible for financial discounts, but there is no financial assistance form on file or a lack of supporting documentation.  In the event there is no evidence to support a patient’s eligibility for financial assistance, Amberwell Health may use outside agencies or vendors in determining eligibility and potential discount amounts.  These resources may use demographic and household information and/or credit scoring technology to determine the percent of assistance to apply to the patient’s account.  Patients who meet presumptive eligibility criteria may be granted financial assistance without completing the application. 

Amberwell Health Financial Assistance Guidelines

Family Size

A discount may be given if income is  below:

1

$15,650

2

$21,150

3

$26,650

4

$32, 150

5

$37,650

6

$43,150

7

$48,650

8

$ 54,150

9

$59,650

10

$65,150

Participating/Non-Participating Providers

Not all services are provided and billed by Amberwell Health.  Therefore, the patient will need to discuss financial options and payments with those individual companies; including but not limited to professional radiology, specialty physicians, and pathology.  The following is a general listing of participating and non-participating providers.  Please inquire with any questions as providers listed may change.

Participating Providers

Alexander, Robin CRNA, Anesthesiology

Bakri, Sarah, DNP, FNP-C Family Medicine

Baum, Jennifer, PA-C General Surgery

Anwander, Annette, MD Family Medicine

Birdashaw, Bella, NP Emergency

Bradbury, Tiffany, NP Emergency

Clevenger, Gerald, PA Family Medicine

Courtney, Elizabeth, NP Family Medicine

Darland, Tyler, MD, Family Medicine

Davis, Elijah, DPM, Podiatry

Duncan, Brian MD, Orthopedic Care

Durbin, Andrew, CRNA Anesthesiology

Enneking, Bonnie, NP Family Medicine

Gernon, Crosby, MD, Radiology

Graham, Mandy, Speech Therapy

Green, Norma E., MD, Family Medicine

Grimes, Russell, DPM

Gernon, Craig, MD Cardiology

Groth, McGarrett M., DO, Internal Medicine

Hart, David W., DNP, CRNA Anesthesiology

Jagels, Danielle, FNP, Family Medicine

Jarvis, Jessica, MD Family Medicine

Jolliff, John MD Cardiology

Kettler, Katie, FNP- C Emergency

Knudson, Paige, CRNA Anesthesiology

Kriwiel, Mariah, MD Family Medicine

Leck, Johnathan K., MD Family Medicine

Long, Arlene, NP Family Medicine

Lueger, Dana, Dietitian

Manning, Kristen, NP Emergency

Meats, Carli, CRNA Anesthesiology

Mueller, Meredith, Occupational Therapy

Meyers, Jason A., MD ENT

Nelson, Joshua, MD PharmD, Orthopedic Care

Nilges, Janae, NP Family Medicine

Petros, Ruth, CRNA Anesthesiology

Potter, Bryan Speech Therapy

Pruessner, Michelle, PA Occupational Health

Radadiya, Shashank, MD Rheumatology

Reece, Micah A., CRNA Anesthesiology

Rooney (Teeter) Lexy J., PAC Orthopedic Care

Rosa, Peter, MD Family Medicine

Rziha, Michaela, PA, Orthopedic Care

Schiebur, Joslyn Physical Therapy

Scholtz, Monica, NP Family Medicine

Selland, Kristen, CNM, APRN Family Medicine

Searight, Lowell, MD Family Medicine

Sherlock, Kellen, MD Emergency

Spangler, Catherine J., DNP, FNP-BC

Stewart, Gabriel, MD Family Medicine

Sudbeck, Mark, Physical Therapy

Tackett, Bonnie, MD Family Medicine

Tackett, Brandon J., MD, Family Medicine

Thomas, Ryan M, MD, Family Practice

Twombly, Jody, PA Family Medicine

Vilander, Cassandra, NP Emergency

Warren, Roderick, MD, Surgical Care

Williams, Dustin, NP, Emergency

Winkel, Caleb, Physical Therapy

Young, Lane, CRNA, Anesthesiology

Non-Participating Providers

The University of Kansas Health System

Caracioni, Adrian, MD Cardiology

Pierpoline, Michael J., DO Cardiology

Wilkins, Diane Y., APRN Cardiology

Dinkel, Kristen E., APRN Cardiology

Boyd, Jonathan D., MD Cytopathologist

Kennedy, Rita APRN Cardiology

Sloan, Kristi, APRN Oncology

Hamilton, Shiloh R., APRN Cardiology

Mamidipally, Swapna, MD Cardiology

Bachelor, Angela T. APRN Cardiology

Vaglio, Joseph, MD Cardiac Electrophysiology

Leifer, Leslie, A., Cardiology

Stormont Vail Health

Dimitriu, Vlad, MD Pulmonary Care

Bernd, Kevin, DO Cardiology

Barberena, Jaime E., MD Interventional Cardiology

Birkbeck, James P., MD Cardiology

Jones, Jack A. MD Interventional Cardiology

Hurtig, James, MD Cardiology

Hakeem, Hisham, MD Cardiology

Morrison, Heather, MD Obstetrics

Doyle, Thomas, MD Emergency

Stallbaumer, Tonya M., APRN Cardiology

Rao, Seshu, MD Cardiology

Seals, Steven E., MD Cardiac Electrophysiology

Gudgell, Amanda, DO Pulmonary Care

Ababneh, Bashar A., MD Cardiology

Patel, Nilay, MD Cardiology

Warren, Michelle APRN Pulmonary Care

Amr, Bashar S., MD Cardiology

Gernon, Craig, MD Cardiology

Mehta, Nikhil, MD Cardiac Electrophysiology

Rahman, Zia Ur., MD Cardiology

Chow, Chen H., MD Cardiology

Kastner, Donney W., MD Cardiology

Radiology Specialist of St Joseph (RSSJ)

Alvarez, Jose F., MD Radiology

Williams, Patrick F., DO Radiology

Bridges, Jack L., MD Radiology

Bruan, John W., DO Radiology

Myers, Timothy, MD, Radiology

Nielson, Brett, DO Radiology

Pal, Michelle L., MD Radiology

Poplaw, Steven, MD, Radiology

Looney, Steven C., MD Radiology

Thurman, Robert D. MD Radiology

Saverino, Benjamin P, MD, Radiology

Wyatt, Alvin R., II, MD, Radiology

Trissell, Brian J., MD Radiology

Renfro, Daniel C., DO Radiology

Mosaic Life Care

Mitchell, David R., MD Interventional Rad

Gortes, Franciso, MD Interventional Rad

Patel Medical Center

Patel, Sudha M., MD Psychiatry

Phoenix Urology

Moore, Bradley J., MD Urology

McPeak Optometry

McPeak, Eric, OD

Mawd Pathology Group, INC

Bush, James W. MD, Pathology

Caughron, Samuel K., MD, Pathology

Hernandez-Rios, Pablo J., MD Pathology

Parris, Jeremy J., MD Pathology

Leonard, Ronald L., DO Pathology

Faber, Erin, DO, Pathology

Shelvin, Douglas W., MD Pathology

Shold, Janna C., DO Pathology

Thomason, Jon G., MD, Pathology

Tawfik, Ossama W., MD Pathology

Gupta, Chakshu, MD, Pathology

Upchurch, Garland M. MD Pathology

Holly, Jason-Scott L., MD, Pathology

Hunt, Edgar L., Jr., MD, Pathology

Kozel, Jessica A., MD Pathology

Dandekar, Monisha N., MD Dermatopathology

LaRue, Steven, MD, Pathology

Pike, John M. MD, Pathology

Spengel, Kenneth C., DO, Pathology

Sramek, Brett W., DO, Pathology

Webster, Natalie, MD Pathology

Rupp, P, Arron, MD Pathology

Schneider, Ashley, MD Pathology

Beavers, T., Charles, MD Pathology

Ewing, David E., MD Pathology

Carmichael, Bradley J., MD, Pathology

Sabetha Community Hospital

Voos, Jennifer L., PA Family Medicine

Saint Lukes Health System

Madigan, Steven K, MD, Pathology

Topeka ENT

Reinecke, Carl M., APRN

Neuenswander, Julie L., AuD

Wohlgemuth, Katie L., APRN

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