Financial Hardship Policy
Tabernacle Rescue Squad (TRS) is a charitable not-for-profit organization under the Internal Revenue Code § 501 (c) (3) which provides 911 emergency medical services to patients without regard to their ability to pay for the services.
If patients are financially able to pay for the services, we expect them to meet their financial responsibilities and support this community service. If however, a patient meets certain requirements detailed below for a hardship waiver, they will not have to pay for the services. We are also able to offer discounted rates to certain uninsured patients, as well as payment plans for those who cannot make the whole payment at once.
Reduced Charges for Uninsured Patients
Patients without insurance are eligible for reduced charges (115% of Medicare) if the patient’s insurance benefits have been exhausted, or if the services provided by TRS a non-covered services.
Financial Hardship Waiver
If a patient provides a copy of Charity Care or Hospital Financial Assistance Program Acceptance letter from a NJ hospital, the patient is entitled to the same discount given by the hospital, or the discounts below, whichever is higher:
· Family gross income is below 200% of the Federal Poverty Guideline (FPG)- full waiver of fees.
· Family gross income is 201% to 300% of FPG – waiver of 60% of fees
· Family gross income is 301% to 500% of FPG – waiver of 30% of fees
Payment Plan
When a patient can not pay the full amount due at one time, TRS’s billing agent shall work with the patient or their representative to develop a payment plan.
All requests for consideration under the TRS Hardship Policy must be accompanied by a completed Tabernacle Rescue Squad Hardship Application. If you require a form mailed to you, please call 609-268-0671 ext. 201 and leave a message including the patient’s name, the date service was provided, and contact information.
Failure to comply with the terms of this policy or agreed-upon payment plan will result in unpaid amounts being referred to collection.
Submit Hardship Application to the Address Below
The charges for EMS transport billing may be modified, based upon a demonstrated showing of an individual’s financial hardship. These procedures will ensure just and fair evaluation of a hardship waiver request as well as establish an audit trail for future use.
1. No one will EVER be denied necessary medical transport service due to either their inability to pay or a lack of insurance.
2. Tabernacle Rescue Squad will address cases of financial hardship on an individual basis.
3. Patients who are uninsured, unemployed, homeless, or for other financial hardship reasons unable to make payments may request a financial hardship review of their transport charge. Patients, or their designee, shall complete the “Request for Transport Fee Hardship Fee Modification Form” and submit documentation to support their hardship waiver request. The form is available on the Tabernaclerescue.com web site or by calling 609-268-0671 ext. 201.
4. This fee modification application and accompanying documentation will be forwarded to the TRS appointed administrator or designee for review and decision. The Tabernacle Rescue Squad Trustees will make a final decision that will be noted on the form. The President of TRS and two Trustees (or their appointed designee) may waive all charges, reduce the charges, establish a payment plan or deny the request. All final resolutions will be communicated to the individual submitting the request.
If approved for a waiver or modification, a copy of all documentation will be made and it will be held in the Tabernacle Rescue Squad’s files for a period of ten years. The original form will be transmitted to the billing company authorizing the waiver or modification of the patient’s charges. The Tabernacle Rescue Squad will notify the patient in writing as to the final disposition of the Hardship Waiver.
