Purpose

Western Berks Ambulance Association, hereinafter referred to as WBAA, has established this policy in order to maintain consistency in assisting uninsured and indigent patients who request a reduction or waiver of certain ambulance charges and/or copayment amounts.

This policy outlines WBAA’s policies and procedures in relationship to the application and approval process for indigent patients. WBAA will take into account the overall financial circumstances of the applicant and apply this policy consistently.

If approved, WBAA may elect to reduce or waive certain amounts which are due from non-subscribers who can successfully demonstrate that paying ambulance fees would cause significant financial hardship.

Financial Hardship Criteria

WBAA will take into account a range of factors when deciding whether the full payment of the ambulance charges will cause the applicant financial hardship. In making the decision whether to waive the fee, WBAA will compare the amount earned, living expenses, assets and debts. Written verification, when available, may be required to substantiate and verify information contained in the financial hardship application.

WBAA uses a combination of the current year’s federal poverty guidelines to help in determining if an applicant qualifies for a financial hardship waiver.

In applying these guidelines, WBAA will also consider and take into account any other income and expenses including:

Money earned in the entire household:

  • Income and employment status verification may be required; including tax returns, check stubs, etc.

Whether payment of the ambulance charges will affect the applicant’s ability to pay for the following living expenses:

  • Food and clothes;
  • Rent or mortgage payments;
  • Any other basic needs; or
  • Any special needs (for a serious illness or disability)

Whether the applicant owns any assets, such as a car or house. Assets also include:

  • Investments;
  • Money in the bank;
  • Cash on hand for short term expenses; and
  • Money designated for special needs

Whether the applicant has any debts.

If you believe you qualify for Financial Hardship Status CLICK HERE to download the Financial Hardship Documentation and application