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Wiki Financial Hardship form

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skanderson

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Does anyone have a Financial Hardship form (or sample) to share when patient's claim they are unable to meet their obligations? Also, what information do you request from the patient in order to consider "financial hardship" write offs? Thanks.
 
We follow the Federal poverty guidelines. You can go online to find them. If the patient's yearly income is at or below the poverty guidelines they qualify for a hardship. We also have the patient give us copies of all income (Medicare retirement, prior year taxes, paycheck stubs, etc..)
 
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