Paul Szmal: FLX Morning continues now on Finger Lakes News Radio. It's 841. The temperature is 64. And we're joined by our friends from Finger Lakes Health. First off, let me bring in Kim Alacua. Kim, good morning. How are you this morning?
Kim Ilaqua, Kathy Finizio: Good morning, Paul. I'm great. How are you?
Paul Szmal: Doing well, as always. Good to see you.
Kim Ilaqua, Kathy Finizio: It's nice to see you, too, on this beautiful morning. Yes. So, would you like to do the honors of introducing our guest and our topic for today?
Paul Szmal: Yes. Today we're going to be talking about financial aid. We know that it's important for people to receive health care and not everyone has the ability to pay. And part of our mission is that we care for everyone, regardless of a patient's ability to pay. And we know that Medicare and Medicaid does not cover the entire cost to deliver care. So through our financial aid program, we're able to assist patients to receive the care that they deserve. So today we have Kathy Fenizio with us. She is our Director of Patient Financial Services and she's going to talk about our financial aid program. Good morning, Kathy. How are you?
Kim Ilaqua, Kathy Finizio: Good morning. I am good, thank you.
Paul Szmal: Good. Good. How many years now with Finger Lakes Health?
Kim Ilaqua, Kathy Finizio: Many. Many. About 25 years.
Paul Szmal: Wow. 25 years. Well, congratulations on that. So I've seen financial aid and many things change over the years.
Kim Ilaqua, Kathy Finizio: Thank you for the congratulations. Yeah. No problem. No problem. Something that came to my mind when I found out that this was the topic, and you actually have I think in your notes the very same thing we were just talking about, which is that there is still that stigma out there that people have of, well, I probably need to go to the doctor, but I don't think I can afford to go.
Paul Szmal: That is correct, absolutely. And we try to take that away because we don't want people making decisions about their health care based on their ability to pay. There are resources out there. So in every year, insurances apply more towards your deductible and less in payment to us, and so the patient gets hit with that higher deductible, and that increases year over year. Again, we want people to seek medical services and not be concerned about the ability to pay.
Kim Ilaqua, Kathy Finizio: I do want to talk about a couple other items that are available, for example, New York State Exchange. So we can provide financial aid for services that we cover, the hospitals, our doctors, etc., but we can't provide financial aid to external pharmacies or services that you're going to need outside of us. Now if you're a hospital in New York State, you do have to offer financial aid to patients. This isn't specific to us, but pharmacies don't, etc. And we want our patients to have continuous care. So ideally, we would like to get somebody in the New York State Exchange, meaning to have insurances and insurance. And that's been around for about 10 years.
They are going to be making some changes to that, I feel, based on changes at a federal level and how it will impact New York State. When this rolled out 10 years ago, every state had to have an exchange program for patients to go in and get, or their constituents, to get insurance. New York State took it to a really great level. So there's a lot of opportunity for New York State people, but it's not so much in other states. It doesn't have to be exact state to state. Anyhow, we think there'll be changes with federal law that is going to be rolling out. There's a lot of health plans available. When this first started, it was very limited in insurances that you might not want to get into, but now there's many levels, and it's dependent on your income as to how much you pay for your insurance. And enrollment will start November 25th and goes until January 31st of 2026, unless you have a life-changing event.
Paul Szmal: Right. And that's how I've been actually getting my health insurance ever since the New York State Health Exchange came about. And I've noticed that, yeah, there's been more variety and more options that have been available as time has gone on. Hopefully those options are retained here with the changes at the federal level. But again, it's kind of too soon to tell.
Kim Ilaqua, Kathy Finizio: Absolutely. And there's a lot of patients that get their insurance through the exchange because employers don't offer it as much as they used to, and it's different levels. So now perhaps a patient can get through their employer insurance just for themselves, but not for their spouse. And their spouse may not have an employer that doesn't offer insurance at all, so they have to go to the exchange. So things are changing compared to 25 years ago when I first got into this business, for sure.
Paul Szmal: Absolutely. And even if you don't have insurance, there are options available.
Kim Ilaqua, Kathy Finizio: Yes. We're getting there. That is why I'm here, financial aid, right? But I want to say that for the New York State Exchange, our certified application counselors are available 730-4, Monday through Friday. They will gladly help you through it. And facilitated enrollers are also available in the community. They can meet you at a library or something after hours, and it's convenient for you. So now to get into the good part, the financial assistance. So we had some changes that came into law October 20th of 24. There was a lot of...they were pretty substantial changes, and us, along with other New York State providers, didn't implement it on October 20th. Well, what actually happened, the New York State gave us the final ruling October 18th at 5 p.m. It was a Friday, and this was going in October 20th. So we had really, in essence, two days. Now we knew about it, but they didn't give us the final reg until two days before. So at any rate, we have made the changes. It is more...you are able to get more financial aid than you were, although we are very generous as an organization. We offer more than even the state requires us to have.
So financial aid is applicable to all areas of our organization, hospitals, clinics, PC doctors, the whole...anything under our umbrella as UR Medicine, Geneva General and Soldiers and Sailors Hospital. So we also have a listing on our web, and you can get it if you call us and request it. Any or all service locations that offer it, and all doctors. That was a new regulation. So every single doctor that we employ that will offer financial aid is on that list.
Paul Szmal: Ah, okay. Yeah, that's new. I probably put it out there like a month ago or so.
Kim Ilaqua, Kathy Finizio: Right. I mean, we have to maintain it, obviously, as our doctors retire or what have you. And every clinic, etc. Or you can just give us a call. So financial aid is applicable to medically necessary services. So if you want some cosmetic services, financial aid doesn't apply to that, unfortunately, or I would have done that. But something like having to visit a doctor for a particular ailment or even...
Paul Szmal: Absolutely. Preventative.
Kim Ilaqua, Kathy Finizio: Yes, preventative care. Those sorts of things. Those are covered under the financial aid guidelines. Yeah, really the only thing that isn't is cosmetic and our long-term care facilities. Because long-term care is considered your home, so financial aid isn't applicable to that.
Paul Szmal: Right, right. One of the... A good change is our applications are now good for one year. It was three months at one time, six months at one time. Now they're one year. You don't have to apply again for one year, which is very beneficial to us having to process them and to our community, because they don't have to dig out all the paperwork and reapply. And you're going to get a letter from us, this is also new, about a month before your financial aid is going to expire saying your financial aid is going to expire, please contact us.
Kim Ilaqua, Kathy Finizio: Right. Which is good, so you don't have to track it as a patient, like, oh, I got to reapply. You can apply for financial aid before your service, while you're sick, during your services, or after. So, even three months later, you're paying on a bill, and you say, hey, I really can't afford this, you can apply then. It doesn't have to be right at the time of your services.
Paul Szmal: Nice. Our application, if you are applying, it used to be two pages. Now because the state is more involved and made changes, it's five pages now. But a lot of the pages are just informational. So it really shouldn't be any harder than any other application you've done in the past.
Kim Ilaqua, Kathy Finizio: Right, so don't be just scared by the page length.
Paul Szmal: No, no. Right. I just, when I first saw it, I said, five pages? That's probably typical of the state, to add additional pages. So historically, our financial aid was a sliding scale. So if you had this many people in your household, and you made this much, you would get percentage off on a sliding scale. And it's still based on a sliding scale, but it's a little more complicated. So as it was before, anyone 200% and below the federal poverty guidelines gets 100% financial aid. That's how it was before, that's how it remains, which is great. And if you have four people in your household, and you're making $64,000, that would be 100%. That was just an example.
Kim Ilaqua, Kathy Finizio: Okay. I just pulled that off of our chart to tell you. You can still, I mean, $64,000 with four in your family, you can get 100%.
Paul Szmal: Wow. Yeah, that's pretty good.
Kim Ilaqua, Kathy Finizio: Yeah, that is good. So the new requirement splits patients up into a group of uninsured and underinsured. So if you have no insurance, or if you have insurance, and they're treated differently. So the underinsured is now based on Medicaid reimbursement. So we take your bill, $1,000 bill, and if Medicaid is going to pay us $200, which is a real example, and you fall within 201 to 300% of the federal poverty guidelines, you will get, you'll only have to pay 10% of that bill. So if the Medicaid reimbursement is $50, you would only have to pay $5. Even though if your bill was actually $1,000, we look at the Medicaid reimbursement first. That is new, and that was a little hard to work through, and I think that's why the hospitals, it took them a little while to get this rolling, because we had to figure out how that was going to look. But that's very positive for our patients that fall within the federal poverty guidelines that have no insurance.
I thought you were going to ask something. Between 301% to 400% of the federal poverty guidelines, you get 20%. So in the case of the $50, it would be $10 that you would owe. If the income is not within 400%, the self-paid discount will remain at 60% of our charges. So if you have no insurance, but you're not within the federal poverty guidelines, you still get 60% off your bill, and that's been around. That's not new.
Paul Szmal: Yeah, exactly. But that's good, because it brings it down to the rate that people with insurance would pay. That's the deal of it. So we can't charge you with no insurance $1,000, and someone who has insurance, we're only charging them 40%. So it brings everybody down to the same playing field.
Kim Ilaqua, Kathy Finizio: Okay. Okay. That makes sense. Okay. I'm glad you're saying it's making sense, so that I'm not ...
Paul Szmal: Nope. Nope. I totally get it. Okay. So underinsured, meaning someone who doesn't have great insurance that doesn't pay 100% right? So the state defines underinsured as patients whose paid medical expenses have exceeded 10% of their income in the past 12 months. So that is how the state defines it. That's what you're required to give patients. What we do, we've historically done this, is we went back to that sliding scale for our other patients. Because there's not a lot, there is a lot of patients, but not all of our patients are going to meet that 10% of their income in medical expenses. So we have to give the patients who say have Medicare and don't have a secondary, or Medicare and not a great secondary, and they don't have that many medical expenses, we need to give them the opportunity for financial aid. That is not required by the state, but we've always been more generous at our hospitals with our financial aid program.
Kim Ilaqua, Kathy Finizio: All right. All right. We're almost out of time. We've got about a minute to go here, believe it or not.
Paul Szmal: Yeah. I could go on and on here.
Kim Ilaqua, Kathy Finizio: No, but this has been tremendously informative. Is there any other quick points you wanted to make?
Paul Szmal: We do offer payment plans too, so if you don't fit into these, we will offer a payment plan that works with your income and what works for you, not anything that we say you have to pay this amount.
Kim Ilaqua, Kathy Finizio: All right. Wonderful. Thank you so much. I appreciate all the information. I have learned a few things that I didn't know today, and I hope our audience has as well.
Paul Szmal: Can I just add one thing?
Kim Ilaqua, Kathy Finizio: Sure.
Paul Szmal: I just want to just reinforce that it's just we really want the community to come to us for care, and please don't let your financial situation... Don't let your financial situation... Prevent you from coming to see us, because our financial aid program is here for you. Ask the question. That's the bottom line. Financial counselors that will help you through the whole process, whether you want to do New York State Exchange, financial aid, we are here to help you.
Kim Ilaqua, Kathy Finizio: Awesome. Well, thank you so much, ladies. Appreciate having you here, and great information as always.
Paul Szmal: Thanks for having us.
Kim Ilaqua, Kathy Finizio: All right. Thank you. It is 855 on FLX Morning.
