Collection Policy


All services provided by Holy Family Memorial, Inc. shall be available to all individuals under this policy with the expressed exception of non-medically necessary services. The Network may however, refer an individual to alternative programs or services within the community where appropriate programs and services are available and where such referrals do not place an undo burden on the patient or family. The Network will also actively pursue and assist the individual in pursuing alternative sources of payment from third parties. Confidentiality of information and individual dignity will be maintained for all who seek services at Holy Family Memorial, Inc.


  1. If a patient cannot pay the minimum required payment, Extended Financing and/or Community Care (Policy 950-343) will be offered.
  2. Accounts under the facility defined dollar amount ($10.00) are adjusted to small balance write off. Exceptions to these dollar amounts must be approved by the appropriate manager.
  3. Accounts placed with a collection agency may be eligible for Financial Assistance only when the application for assistance is received within 240 days of first notification that the balance is due. If they are eligible for Financial Assistance the account(s) will be adjusted appropriately based upon the Federal Guidelines. However, any balance remaining is due in full within 30 ays or professional collection efforts will resume. During the Financial Assistance application period (240 days), HFM will suspend all extreme collection activities until determination eligibility is made.
  4. Financial information will be discussed and/or released to:
    • Guarantors and/or their spouse
    • Patient’s power of attorney
    • Attorney with written authorization
    • Collection agencies under contract with Holy Family Memorial, Inc.
    • For Behavioral Health, a written authorization is required to release billing information to anyone other than the patient and/or guarantor as specified in State Laws 51.30 and HFS 92.03(3).
    • No information will be released to third parties without patient’s written or verbal authorization.
    • No information will be released to parents of children over the age of 18 years old at the time of service without the patient’s prior authorization.


  1. All insurances are filed prior to the collection of self pay. Insurance co-pays, deductible/ co-insurance may be requested and collected, when possible, at time of service.
  2. Medicare
    • Holy Family Memorial Network (HFM) facilities accepts Medicare assignment.
  3. Self Pay
    • Patients with no insurance will be billed as self pay. These patients having clinic services will be required to pay a $75 co-pay at the time of service.


  1. Request payment in full.
  2. Payment plans:
    • If full payment is not possible, payment plans must be set up with a Financial Advisor. All accounts must be paid in full within 6 months of the balance becoming self pay. Due date will be marked clearly on each patient statement.
    • All Network facilities will offer Payroll Deduction to HFM employees. A reduced payment arrangement, is also available to HFM employees upon request.
  3. HFM Patient Financial Advisors or authorized eligibility service staff will interview patients admitted without insurance.
  4. Patients will be informed of assistance which is available through various government entities.
  5. Cash, Check, HFM Gift Cards, Auto Withdrawal from savings or checking, MasterCard, VISA, and Discover are available for payments.
  6. All patients with a self pay balance will be reviewed for Presumptive Charity.
  7. Financial Advisor should proceed with Non-payment or Insufficient Collection Procedures if the responsible party does not pay the balance in full within 6 months of balance dropping to self pay.
    • Holy Family Memorial will make reasonable efforts to orally notify patients with a self pay balance of all payment options and financial assistance that may be available to them.
    • All patients will receive at least 3 statements and 1 final notice before any account is sent to a professional collection agency, or extraordinary collection actions take place. This final notice will be provided to the Patient at least 30 days before the deadline specified in the statement. A Plain Language Summary will accompany this final notice. It is the Patient obligation to provide a correct mailing address or email at the time of service or upon moving. If an account does not have a valid address, the determination for “Reasonable Effort” will have been made.
      • Contact information and website is listed on all collection letters, statements, and the Plain Language summary.
    • If a patient applies for Financial Assistance and is denied, the patient will have up to 6 months to pay the bill in full. The patient will be informed of all other payment options available to them by mail in the denial letter. The same collection process will take place as listed in 7(a,b).
      • If there is missing information on the Financial Assistance application, a letter will be sent to the guarantor to complete the application.
  8. Collection Agency may take any and all legal actions, including Extraordinary Collection Actions, to obtain payment for medical services. These legal actions include but are not limited to credit bureau reporting, legal or judicial actions, telephone calls, emails, texts, mailing notices, and skip tracing to obtain payment for medical services provided.


  1. Bankruptcy – If no assets, the account will be written off. If there are assets, a Proof of Claim form must be completed.
  2. Hospital Liens – A hospital lien will be filed with the Clerk of Courts within 30 days of discharge when a patient is admitted as a result of an accident and does not have health insurance.
  3. Probates – A claim against an estate is filed when appropriate.
  4. Litigation – When a letter of protection is received from an attorney, the account will be reviewed for possible temporary suspension of personal payment collections.

Download the Collection Policy PDF.