Uncompensated Care Providers,

HHSC is attempting to gain a comprehensive understanding of charity care policies in Texas hospitals. Particularly, we would like to understand how providers set their policies, how such charges are reported, what other reimbursement mechanisms providers depend on, and how both HHSC and providers can account for and identify duplicate patients who may be reported twice in both DSH and UC pools. Please complete the survey below to the best of your ability.

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* 1. Provider Information

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* 2. What is the basis for your charity care policy?

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* 3. How do you determine if an uninsured patient is eligible for charity care? How do you document this patient eligibility information?

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* 4. How is your facility reimbursed for charity care? (churches, charitable foundations, etc.)

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* 5. What kind of impact does classifying certain charges as bad debt or as charity care have to your facility’s overall reimbursement?

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* 6. How has your charity care policy changed to reflect upcoming DY 9 reporting requirements?

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* 7. Due to UC now reimbursing for uninsured charity care, have you chosen to classify more costs for uninsured patients as charity that would otherwise have been classified as bad debt costs?

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* 8. How do you capture charity care-qualifying patients in your patient accounting system?

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* 9. What would you be able to send as supporting documents for uninsured charity care charges?

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* 10. What would you be able to send as supporting documents for uninsured charity care payments?

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* 11. In the upcoming applications, HHSC will ask providers to split their uninsured charity charges and payments between IP and OP, and identify the days associated with the IP charges.

Do you foresee any issues identifying the days associated with the IP charges or splitting the total charges/payments between IP and OP?

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* 12. As related to uninsured charity care costs and charges, what types of issues have you historically encountered that you believe will continue post-September 30, 2019?

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* 13. Questions 13 - 15: only for DSH hospitals also participating in UC:

The applications will calculate uninsured charity care cost using the uninsured charity charges from Worksheet S-10 of your cost report ending two years prior to the current demonstration year, and DSH providers will report their DSH uninsured using discharge dates during the federal fiscal year (October 1, 2017 - September 30, 2018) for DY 9.

For your facility, how much of an overlap is there between uninsured patients included in DSH and those included in uninsured charity care?

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* 14. What is the reason for the overlap or lack of overlap?
Is it the difference in the reporting periods, the criteria for capturing both data sets, or something else?

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* 15. What support can you provide to HHSC to validate the overlap or lack of overlap between the DSH uninsured patients and uninsured charity patients?

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* 16. Questions 16 - 18: only for children's hospitals and IMDs:

Do you use Worksheet S-10 for charity care charges?

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* 17. If answered no to Question 16, how does your facility record and report charity care charges?

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* 18. If answered no to Question 16, why does your facility choose not to file an S-10?

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* 19. Based on the intent of this questionnaire, is there any other pertinent information you would like to provide?

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