Financial Assistance

NOTICE OF FINANCIAL ASSISTANCE 
No person, regardless of ability to pay, will be refused emergency medical services in accordance to Internal Revenue Section 501(r)(4).

Application forms are available at the Patient Access Registration Desk and at the Patient Financial Services Department. Click here to download the form. For more information, please contact the hospital’s Patient Accounting Clerk at 810-648-6199.

Financial Assistance Policies

• Amounts Generally Billed
• Eligible Providers
• Ineligible Providers
• Emergency Medical Care Policy
• Financial Assistance Program -Charity Care- A-4-5-6
• Plain Language Summary

The hospital provides a Financial Assistance program for patients that have no insurance or who have out-of-pocket expenses that exceed their financial abilities.

Charges are covered as follows:

• Eligible Charges include emergency, non-elective hospital inpatient/outpatient charges and medically necessary outpatient testing
• Non-Eligible Charges include elective (scheduled) surgery and procedures and non-McKenzie charges

The general eligibility requirements are as follows:

• Family income must not exceed 250% of the federal poverty level
• Family cash assets must not exceed program limits
• Patients who may be eligible for coverage under Medicaid/Healthy Michigan must have applied within the last 6 months and been denied coverage. A copy of the denial letter should accompany the application for Financial Assistance.

Patient Responsibility for Payment

Payment for services provided is the responsibility of the patient or their legal guardian. Patients are responsible for payment of their account balance regardless of any insurance coverage they may have.

Payment Accepted. McKenzie accepts cash, check, Visa, MasterCard and Discover.

Returned Check Fee. The non-sufficient fund/returned check fee is $35.

Billing Information. Please be sure to confirm your billing information with the registration staff.

Update them with any changes such as changes to:

• Insurance Coverage
• Address
• Phone number
• Employment status
• Name
• Marital status

Insurance Coverage. McKenzie participates with many insurance companies. It is the responsibility of the patient to verify that McKenzie participates with their carrier before services are rendered. Patients are responsible for knowing and understanding the terms and requirements of their insurance plan. This includes financial obligations for co-pays, deductibles and co-insurances; pre-authorization certification; and specific laboratory requirements. Co-pays, deductibles, and co-insurances are due at the time of service.

Applying for Medicaid

You can apply for coverage under Medicaid and/or Healthy Michigan on-line at www.healthcare4mi.com. More information, contact the Department of Human Services office, 515 S. Sandusky Road, Sandusky, MI 48471. The phone number is 810-648-4420.

For help completing an application or for more information, contact the McKenzie Social Worker at 810-648-6181.