Financial Support at CTCA

At Cancer Treatment Centers of America (CTCA), we make every effort to ease our patients’ financial burden. It’s another way we help patients improve their quality of life and focus on healing.

The financial support we offer comes in a number of forms: information, advocacy, monetary assistance, and resources. Much like the cancer treatment our patients receive, the financial support we provide is based on each patient’s individual needs.

The information below covers financial support programs which may be available to patients currently receiving treatment at a CTCA facility.

Financial Hardship Program

We offer a Financial Hardship Program to help patients who experience financial difficulty while undergoing treatment. Should you qualify for this program, we will set up a payment plan based on your needs. This can help you meet your financial responsibilities for medical services at CTCA.

Our Patient Accounts and Financial Advocate teams can provide you with a program application and assist in completing the form, on-site or via phone.

We review financial hardship applications on a monthly basis. We look at a variety of factors, including the following, to determine eligibility:

• Financial history
• Income
• Account summaries
• Assets
• Loans
• Taxes
• Other financial-related information

If patients qualify for the program, we customize a plan for them based on their ability to pay for care. For example, eligible patients who qualify may be allowed to make smaller payments over an extended period of time.

Charitable Support

Assistance in Healthcare

In some cases, CTCA patients may struggle to pay for non-medical needs (e.g., utilities, rent, transportation, living expenses) during your treatment and recovery. The Assistance in Healthcare Foundation, a 501(c)(3) charitable organization, helps defray the non-medical expenses of financially distressed cancer patients and their families. As a patient at CTCA, you are eligible to apply for this program.

Assistance in Healthcare reviews its applications monthly. Applications contain requested information on:

• Assets
• Household income
• Expenses
• Other financial-related information

The amount of assistance granted depends on the availability of funds, as well as the applicant’s financial status.

As a public charity, Assistance in Healthcare is funded through donations.

Mary Brown Stephenson Memorial Program

CTCA has a program which assists cancer patients struggling to pay for medical expenses. The Mary Brown Stephenson Memorial Program (named in memory of CTCA Founder and Chairman Richard J Stephenson’s mother) annually allocates funds to provide uncompensated treatment to indigent community members fighting cancer.

The Mary Brown Stephenson Memorial Program has been established at each CTCA hospital. You can apply for this financial assistance program if you:

• Are an uninsured cancer patient living in or near the communities of one of our hospitals
• Meet specific economic need guidelines

A selection committee reviews qualifying patients’ applications, which include the following information:

• Employment status
• Total household income
• Expenses
• Assets
• Loans
• Tax returns
• Other financial-related information

Financial Advocacy

As a patient at one of our cancer hospitals, we will do all of the following to empower you to take control of your financial situation:

• Offer information and guidance to help you navigate through financial and insurance-related issues.
• Fight to obtain appropriate payment of your insurance claims. We work with you and your insurance provider to resolve any claims questions and concerns.
• Strive to fully inform you about your medical bills, insurance claims, denials, and appeals.
• Carefully listen to your concerns, answer your questions, anticipate your needs, and help you find solutions relevant to your individual financial situation.
• Acquire summaries of your insurance coverage so you have a general assessment of what will and won’t be covered at our hospitals before you visit us.
• Call your insurance provider for benefits quotes that include in-network and out-of-network benefits, deductible and co-pay responsibilities, and other relevant information.
• Talk with you to help you understand your benefits.

Helping Appeal Denied Insurance Claims

If you have an insurance claim denied, we will reach out to you. We will first send you a letter and then follow up with a phone call to ensure you are aware of the denial. If the balance you owe is escalating, we may be able to offer you help through one of our financial assistance programs. Or, we may be able to look to other resources, such as pharmaceutical companies’ discount programs.

We offer face-to-face or over-the-phone meetings with our financial advocates to discuss questions about denied claims or other financial issues. In addition, our financial advocates can assist you to work through claim issues with insurance providers. We are willing to conduct conference calls with you and your insurance provider to discuss denied claims, making sure everyone is on the same page and keeping your best interest in mind. Our financial advocates may also be able to help you write an appeal to your insurance provider to contend a denied claim.

Other Ways We Help

Our financial advocates can also help you enroll for insurance benefits. We can explain benefit options and differences among insurance plans in layman’s terms, so you can make informed decisions and get the most out of your insurance coverage.

Our Patient Accounts team can also answer your billing and insurance questions. The team keeps you informed about your healthcare costs at CTCA. Patient Accounts:

• Explains out-of-network coverage
• Tells you if your insurance provider has paid claims
• Provides itemized statements
• Checks on your statement balances

Lastly, if you exhaust all of your out-of-network benefits while at CTCA, we offer to help you transition your care back to an in-network treatment facility.

Partnerships

At CTCA, we have relationships with external companies, non-profits and foundations to assist patients facing financial difficulties or barriers.

Patient Advocate Foundation

Patient Advocate Foundation (PAF), a national 501(c)(3) non-profit organization, can provide new and returning patients with financial and insurance case management. PAF educates and empowers you to make informed decisions. It also negotiates resolutions to issues regarding:

• Denied access to healthcare
• Employment
• Disability
• Ancillary help for needs such as transportation, lodging and drug co-payment assistance

PAF responds to patient concerns, regardless of insurance status. The organization’s case managers mediate between you and your insurer to resolve insurance matters.

Pharmaceutical Alliances

We also advocate for financial assistance related to our patients’ treatment regimens. We access pharmaceutical companies’ financial assistance programs and routinely search for additional resources that promote savings, including:

• Discount programs
• Drug company-sponsored patient assistance programs
• Drug manufacturer coupons

Our hospitals have in-patient pharmacies staffed by pharmacists who are available for individual consultation. Three of our four hospitals also feature full-service retail pharmacies. Each hospital has relationships with major pharmaceutical companies that provide our patients with access to discount programs.

We provide innovative and thorough treatment options based on your individual needs. Sometimes, the most hopeful treatments are off-label drugs (i.e., the use of an approved treatment for any purpose, or in any manner, other than what is described in the treatment's labeling). We leverage support and data from drug manufacturers to appeal drug denials by insurance providers.