SW-XX-51 Ei taropwe e siwini QMC ngeni System-Wide Juun 21, 2016 Annuk me Otoot fan System-Wide non tettenin ewe Queen s Health Systems Ite

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1 SW-XX-51 Ei taropwe e siwini QMC ngeni System-Wide Annuk me Otoot fan System-Wide non tettenin ewe Queen s Health Systems Itenap: CHARITY CARE POLICY ika Pekin Tumwun ese Mö Watte 1. POPUNAPEN AN WOR EI ESINESIN 1.1. Ekewe ekoch patient non ewe Queen s Medical Center non Punchbowl (QMC/P) me West Oahu (QMC/WO), ika Molokai General Hospital (MGH) me North Hawaii Community Hospital, Inc. (NHCH) ese mecheres ar repwe angei aninisin health care tiwan chok ika pwe repwe pwan angei aninisin moni. Ussun a affat non an ewe Queen s Health System kewe annuk, repwe nengeni an eman me eman patient keis pwe repwe pwungueno ika pwe e men tongeni moni niwinin non pioing, iwe ika e men fich ne angei aninis ina repwe mwut ngeni an epwe angei charitable care ika pekin aninisin moni. Faniten ekewe patient ese wor nour insurance ( uninsured ) are/ika ese naf nour insurance ( underinsured ), ei policy e kan esine ngenir met repwe fori ar repwe fich ne angei charitable care ika ekoch discount, ussun a affat seni annuk QMC/P, QMC/WO, MGH me NHCH Ei policy e kan pwung fan pwungun ewe Queen s Medical Center, Molokai General Hospital me North Hawaii Community Hospital, iwe ekewe pioing re achocho ne katonochu an eman me eman patient tongeni pwisin momoni niwinin non pioing, o rese pwan nefinifin aramas won wukukun an eman tongeni moni niwinin non pioing. 2. IO EPWE NOMW FAN TETTENIN EI POLICY 2.1. Ei policy e pochokun ngeni iteiten meinisin ekewe kinikinin non ewe Queen s Medical Center Punchbowl (QMC/P), ewe Queen s Medical Center West (QMC/WO), Molokai General Hospital (MGH) me North Hawaii Community Hospital, Inc. (NHCH). 3. IO EKEWE CHON MWUMWUTAN EI POLICY 1

2 3.1. Ei policy e utta fan pochokunun ewe System Leadership Council, me ewe QHS Board of Trustees, pwan fan pochokunun ewe QHS Executive Vice President, ewe Chief Financial Officer, ewe QHS Executive Vice President, me ewe Chief Operating Officer. 4. WEWEN EKOCH FOOS/KAPAS 4.1. Medically Necessary (Safei/Tumwun Mi Auchea Ngeni An Eman Pochokun: iei a wewe ngeni ekewe ekoch auchean foforen tumwun mei kawor ika katou non pioing ( inpatient ) me nukun pioing ( outpatient ) ika seni eman tokter, weiweitia ika met mei namot ika auchea ngeni eman chon samwaw/semwin pwe epwe tongeni pochokun Pirokramen Health Care mei Kawor Seni Local, State ika Federal: iei a wewe ngeni ekewe ekoch Pirokramen Health Care mei Kawor non muun Sopw ( Local ), muun State ika muunapen Federal, ussun Medicare, Medicare Advantage, Medicare Private Fee For Service, Medicaid, QUEST, TRICARE, Department of Veterans Administration, ika pwan ekoch pirokram mei nomw fan tettenin Federal ika State funding U.S. Coverage: iei a wewe ngeni eu health plan ika insurance kampani mei angang non eu me nein ekewe 50 United States are ika non ekewe fonuen U.S. (pachanong ekewe U.S. territory), ika eu U.S. government health pirokram (ussun Medicare, Medicaid, TRICARE ika ewe VA) Uninsured : iei a wewe ngeni eman patient ese wor noun insurance, nge a chok nomw non tettenin self-pay weiweita ika epwe wisen moni niwinin non pioing 4.5. Underinsured : iei a wewe ngeni eman patient mei wor ekis insurance, ussun No Fault, Travel, AARP Indemnity, me/ika AFLAC, nge ese pwan wor noun insurance ren pekin safei/pioing. An ewe patient insurance ese moni an ewe patient reirei. 5. POLICY 5.1. Ika eman patient ekan nit och sakkun auchean tumwun ika safei nge ese tongeni moni niwinin non pioing anonganong won an woungaw ika weiresin moni, ina repwe tongeni kotur an niwinin non pioing ika pwe e men qualify Ei policy ese moni sokopaten health care services weiweita ika tumwun mei kawor seni eman tokter ese angang non QMC/P, QMC/WO, MGH ika NHCH (pachanong safeian meur ika anesthesiology, x-ray ika radiology me ekoch tokter mei nomw non tettenin private practice ). Taropwe A ( Providers Covered by Policy ika ekewe tokter/pioing mei pwung fan ei Policy) eu taropwe mei mak iten meinisin ekewe tokter mei tongeni etiwa ei policy Fansoun tonong, fansoun registration, ika non fansoun ekan touu seni pioing, repwe screen ika nenengeni ika a wor noun ewe patient insurance are ika a 2

3 tongeni fich ngeni an epwe angei Medicaid, Medicaid Managed Care ika charity care coverage ika aninisin moni. Ewe pioing epwe anisi me aiti ngeni ekewe re mochen angei aninisin safei/tumwun pwe repwe sinei ifa usun ar repwe tongeni fiti ekoch State me/ika Federal Health Pirokram Iteiten fansoun, ewe pioing epwe aiti ngeni eman me eman patient ese wor noun insurance pwe epwe sinei o weweiti ussun ewe application ren aninisin monien niwinin non pioing me ewe Charity Care Policy ika Pekin Tumwun ese Mö Watte Ikei ekewe chon safei rese tongeni angei Charity Care discount: Ekewe patient ir mei qualify ngeni ekoch Local, State ika Federal Health Care Program Ekewe patient re fen wor nour insurance me non Merika weiweita ika U.S. Coverage (katon wewen ei foos asan) Ewe pwinin maram weiweita ika inet atun ewe patient e angei aninisin pekin safei/ tumwun faniten an nuing pioing pwe Medicaid ese chiwen monatiw niwinin faniten ewe patient ese moni met ururun epwe monatiw An eman patient niwinin non ewe Queen Emma Clinics (QEC), Dental ika Aisa Clinic, me Sitowan Saffei ika Pharmacy e tongeni an epwe kotur ika discount pwe epwe eu minimum co-pay chok Ekewe Charity care discount ika Pekin Tumwun ese Mö Watte fan ei Charity Care Policy repwe pwung non eu ier seni 1) ewe pwinin maram won an ewe patient application ren aninisin moni are/ika seni 2) ewe lasinon ran ewe patient e kan nuing ( inpatient ) non pioing. An eman patient fich ika qualification epwe tongeni kouno me mwen eu ier nupwen ika 1) an ewe patient moni tonong ika income ekan siwin, ussun a affat non Taropwe B ( Income & Assets Discount Qualifiers ika Annukun Kotur ika Discount Faniten An Chon Safei Moni Tonong me Pisek) are/ika 2) ewe patient e kawor U.S. coverage. Eman patient e tongeni apply-sefani ren eu charity care discount Fan pwungun ekkei annukun ei policy pwe ika io chon safei mei watte niwinin an safei, ese mö ngeni, mei tongeni an epwe angei aninisin an epwe kotur ngeni momon an safei anongonong won eu me eu keis. Ika eman patient e wor an family income nge ewe ukukun an we bill ika niwinin non pioing mei fakun watte, ina ewe policy epwe tongeni kotur ika ekisatiw an niwinin non pioing weiweita ika epwe tongeni angei eu charity discount ika e men qualify. Ei poraus e nongonong won parakraf TUFICH IKA ELIGIBILITY 6.1. An eman fich ika eligibility epwe anonganong won ewe kauk a iteni U.S. Federal Poverty Level faniten ekewe rewinipwos ika U.S. citizen me ekewe U.S. resident, me ewe kaukun minimum wage ren ekewe rese nomw non fonuen Merika, are ika ar kewe assets weiweita ika wukukun niwinin pisekir mei kis seni $25,000 non eu ier. Katon Taropwe B 3

4 Eni eman patient epwe tongeni fich ne angei eu charity care discount ika ese wor noun insurance, are ika ese naf noun insurance, me ewe ukukun an income mei nomw non tettenin woungaw ussun a affat non Taropwe B, me ika ewe patient e fen fori ewe Application ren Aninisin Monien Niwinum non Pioing (Taropwe C), pachanong ekoch taropwe mei pwarata an income ( income verification documents ) Ion chon safei a fen nounou ewe Medicaid/Quest non ukukun eu ier, a tongeni an epwene qualify ngeni, iwe ewe aninis ekan angei epwene kouno. 7. MET KOPWE FORI OMW KOPWE APPLY NGENI CHARITY CARE 7.1. Eman me eman patient e tongeni apply ngeni aninisin charity care fan ei Policy ika pwe epwe amasowa eu financial assistace application o atoura non eu ofesin QHS Patient Access department, ika eu QHS Business Services department. Repwe tongeni etiwa eche kapin noun ewe patient Med-Quest application pwe akasiwinin noun we application ren aninisin moni Ka tongeni angei noum kapin ewe application ren aninisin moni non an ewe pioing website Ika ese wor noun eman patient insurance, iwe ewe pioing epwe pachanong porausen ena pirokramen aninisin moni won noun ewe patient billing steitment ika taropwen niwinin non pioing. 8. ANNUKUN ME OTOOTEN REFIWIN EU ME EU APPLICATION REN ANINISIN MONI ME CHARITY DISCOUNT (KOTUR) 8.1. Ren ewe pioing epwe apwunguweno an eman patient fich ngeni an epwe angei eu discount (kotur), fan pwungun Taropwe B. Ekewe chon angangen Patient Access ika Business Services repwe nengeni ewe patient application ren charity care pwe repwe apwunguweno wukukun an we income ika moni tonong Ussun a affat non Taropwe B, repwe esine ngeni ekewe patient re nomw non ewe asset limit pwe ir mei aprufini ar we tungoren discount. Wukukun ewe discount epwe anongonong won ukukun ekewe persen, ussun a affat non Taropwe B. Mwurin ewe patient epwe angei an discount, ina repwe pwan anisi an epwe tongeni moni met ururun epwe monatiw me non eu payment plan Ussun a affat non Taropwe B, repwe esine ngeni ekewe patient rese nomw non ewe asset limit pwe ir resap aprufini are we tungoren discount Ekkewe chon angangen non ofesin Patient Access ika Business Services repwe nengeni an ewe patient self-pay account weiweita ika met ururun epwe monatiw pwe repwe pwungueno ika ewe patient a fen fich ika qualify ngeni Medicaid/QUEST are ika a fen kawor niwinin non pioing mei fen moni seni Medicaid/Quest. Ekewe chon angangen non ofesin Patient Access ika Business Services repwe anneani wukukun an ewe patient discount anongonong won Taropwe B. 4

5 Ekewe chon angangen non ofesin Patient Access ika Business Services repwe esine ngeni ewe patient ika a tongeni angei eu discount iwe repwe pwan anisi an epwe tongeni moni met ururun epwe monatiw me non eu payment plan Ika eman patient e fich ne angei aninisin moni fan ei Policy, iwe esap chok moni napeseni met ururun epwe monatiw faniten pekin emerchensi ika pwan ekoch sakkun pekin safei/tumwun me non ei pioing. Ussun a affat non annukun federal, a men auchea an eman me eman patient niwinin non pioing epwe nomw non tettenin general billing amount fan pwungun ewe pirokramen Medicaid feefor-service (weiweita ika met ururun Medicaid me Medicare repwe monatiw fengen) Ekewe patient ese wor nour insurance repwe tongeni eligible ika fich ngeni ar repwe chok angei eu minimum discount fan Schedule B, Income and Asset Qualifiers and Discount Rates weiweita ika Otooten me Annukun An Chon Safei Income me Asset. Ekei pioing repwe esine ngeni chon safei ar repwe apply ne angei aninisin moni fan pwungun ei policy. 9. MET EWE PIOING EPWE FORI IKA EMAN PATIENT ESE MONI MET URURUN EPWE MONATIW. Ikei ekoch foforen mwokutukut ekei pioing repwe tongeni fori nupwen ika eman patient e niwinimang weiweita ika ese moni met ururun epwe monatiw faniten an we pekin safei/tumwun non pioing An ena patient account epwe ne katouronong non eu collection agency Ekei pioing resap tongeni fori ar repwe kapwung ngeni eman patient ika fori collection, tiwan chok ika: An ewe patient niwinimang epwe mang seni 120 ran seni ewe pwinin maram won an ewe chon safei aewin steitment ika bill seni inet atun e kan touu me ewe pioing. Re nenengeniochu an ewe patient account pwe repwe tongeni pwungueno ika a men qualify ngeni an epwe angei aninisin moni fan pwungun ei policy. Re fakun achocho ne kokori ewe patient me non fon pwe repwe poporaus ngenii ussun ei Policy me met epwene fori an epwe tongeni apply ne angei aninisin moni. Iwe io chon safei e fori ar repwe kapwung ngeni pwan eman aramas ( third party ) faniten och feiengawen non inis, ese nomw fan pwungun ekei annukun ei policy. An ewe patient account e fen apprufini meren ewe QHS Legal Department pwe repwe fori ar repwe kapwung ngeni. 10. REKOTEN ME FOFOREN ACCOUNT 5

6 10.1. An eman me eman patient taropwen tungoren aninisin moni me charity care, ika pwan iteiten meinisin ekewe taropwen application, repwe isois me non ar rekoten account Inet atun ewe pioing re finata pwe eman patient mei qualify, iwe repwe mwutir rekotenong porausen an fich ngeni charity care me non an ewe patient account. 11. ESINESININ EWE CHARITY CARE POLICY NGENI CHON SAFEI ME PWAN ARAMAS MEINISIN Ekei pioing repwe wisen esine ngeni chon safei pwe ir mei qualify ika fich ne angei charity care, iwe repwe aea ekei metochen esinesin: taropwen bill ika niwinimang, me ekoch post non ekoch nenien non pioing. Ekoch auchean poraus epwe pwan pachanong non an ekei pioing website. Eu kapin ewe Charity Care Policy non Foosun Fonuom ( Charity Care Policy Plain Language Summary ) ika Pekin Tumwun Ese Mö Watte me Mesenapen Poraus Non Foosun Fonuom mei pachonong, iwe a iteni Taropwe D Ka tongeni angei noum kapin ei taropwen Charity Care Policy ika Pekin Tumwun Ese Mö Watte ika ke tungor ren eman chon anisi non pekin Patient Access ika Business Services me non ekei pioing. Ka tongeni angei noum kapin ewe Financial Assistance Policy ( Policy Ren Aninisin Moni ), me ewe Application ren Aninisin Monien Niwinum non Pioing ( Finanacial Assistance Application ) me ewe Mesenapen Poraus Non Foosun Fonuom ( Plain Language Summary ) non ekkei foosun fonu: Japanese, Samoan, Vietnamese, Korean, Chinese, Tongan, Chuukese Illokano me Tagalog Ekei pioing repwe awora chomong kapin ei taropwen policy ngeni sokopaten pekin/pirokramen aninis weiweita ika community organizations non Hawaii pwe aramas mei woungaw repwe tongeni angei nour aninisin safei non pekin pioing (ussun Institute for Human Services, Kokua Kalihi Palama, Waianae Coast Comprehensive Health Center, Waimanalo Health Clinic). Ika a wor omw kapas eis ussun ei policy, kosemochen kopwe kori ewe Manager, non ewe ofesin Business Services ren Robert Nobriga Executive Vice President me Chief Financial Officer Jason Chang Executive Vice President me Chief Operating Officer Menni Taropwe Mei Pachanong: 6

7 Taropwe A - Ekewe tokter/pioing mei pwung fan ei Policy ( Providers Covered by Policy ) Taropwe B - Annukun Kotur ika Discount Faniten An Chon Safei Moni Tonong me Pisek ( Income & Assets Discount Qualifiers ) Taropwe C -Application ren Aninisin Monien Niwinum non Pioing ( Financial Assistance Application ) Taropwe D - Charity Care Policy non Foosun Fonuom ( Charity Care Plain Language Summary ) Ei Taropwe E Apprufini Meren: QHS System Leadership Council non Mei 27, 2016 Ei Taropwe E Apprufini Meren: QHS Board of Trustees non A Awora Ngeni: Meinisin Ekewe Kampani fan tettenin Queens Ei policy/taropwen otoot a for faniten meinisin ekewe pioing ika kampani non tettenin ewe Queen s Health Systems, iwe ese wor pwan ekoch aramas, pioing me/ika kampani repwe tongeni nounou ei policy, tiwan chok ika ir repwe akomw angei ar mwumwuta. Taropwe A Ikei ekoch website mei mak iten ekewe tokter/ pioing mei pwung fan ei policy: pdf 7

THIRD CHUUK STATE CONSTITUTIONAL CONVENTION Weno, Chuuk State Federated States of Micronesia Journal of the Constitutional Convention 55th Day (

THIRD CHUUK STATE CONSTITUTIONAL CONVENTION Weno, Chuuk State Federated States of Micronesia 96942 Journal of the Constitutional Convention 55th Day (Friday) August 20, 2004 2:00 p.m CALL TO ORDER A suk