SMCS is committed to meeting the needs of residents of its defined service area by offering a sliding fee scale to all income-eligible uninsured or underinsured patients based on annual household income. Under no circumstances would SMCS withhold emergency medical care to any individual.
SMCS offers a Financial Assistance Program (FAP) to reduce the burden of medical expenses for patients who demonstrate financial need through discounted care based upon family income in relation to Federal Poverty Level guidelines.
There is no residency requirement for medical services provided by the SMCS Community Health Center Network (CHC), including dental and ophthalmology services.
1. In order to be eligible for assistance for services provided by Springfield Hospital, the patient/guarantor must be a resident of the State of Vermont, or Sullivan or Cheshire Counties in New Hampshire. Applicants who reside outside Vermont or the indicated New Hampshire counties, and who have been deemed eligible for assistance for CHC services, may also be deemed eligible for Springfield Hospital assistance.
2. In order to be eligible for financial assistance for dental services or the 340B prescription drug program, applicants must have selected the CHC as their primary care provider or reside in one of the following Vermont towns: Andover, Athens, Baltimore, Cavendish, Chester, Grafton, Jamaica, Landgrove, Ludlow, Londonderry, Mt. Holly, Peru, Plymouth, Reading, Rockingham (Bellows Falls), Springfield, Stratton, W.Windsor, Weathersfield, Westminster, Weston, and Windham, Winhall, or NH towns of Acworth, Alstead, Charlestown, Langdon and Walpole.
This financial assistance is for services provided and billed by Springfield Medical Care Systems.
If you are declared eligible for financial assistance, your eligibility will be in effect for one year. Please notify Springfield Medical Care Systems of any bills that you receive from the date that you made application and the date you are notified of approval.
Please note the following companies DO contract with our financial assistance program.
• BlueWater Emergency Partners
Should you receive a bill from this company, please mail them a copy of your financial assistance award letter that shows the percentage you were granted. It is your responsibility to send them a copy of your financial assistance award letter to avoid collections. Should you be sent to collections, your financial assistance can no longer be applied.
Springfield Medical Care Systems’ (SMCS) and Springfield Hospital’s (SH) financial assistance is only for services billed by SMCS and SH, and applies only to medically–necessary services. Elective services are not covered. Most other services are covered under the financial assistance policy, including visits to your primary care doctor. Please inquire prior to having medical treatment as to whether or not the service is covered by the financial assistance policy.
To determine whether a specific provider’s services are covered under our Financial Assistance Policy, please refer to the Physician Finder section of our website. Each provider’s biography page indicates whether they are participating in our financial assistance program.
Springfield Hospital will not charge eligible patients more for emergency or other medically necessary services than the amount generally billed (AGB) to patients who have Medicare. The amount generally billed (AGB) is calculated based on the percentage of what Medicare allows for services billed in a 12 month period. The percentage calculated will be multiplied times the total charges on the claim to arrive at the AGB. Sample methodology is included in Schedule (E) of the Financial Assistance Policy.
SERVICES NOT COVERED
Services excluded under our Financial Assistance Program for Springfield Medical Care Systems (SMCS), Springfield Hospital (SH), and Springfield Specialty Practices (SSP) are as follows:
Elective services are not covered.
Patients are encouraged to inquire prior to having medical treatment as to whether or not the service is covered by the financial assistance policy.
Cytology for pap smears and HPV testing.
Dartmouth Hitchcock provides cytology for pap smears & HPV testing. These services are not covered under our financial assistance program. Please contact Dartmouth Hitchcock directly to apply for their financial assistance.
Services provided by hospitals or companies that are not owned by SMCS or Springfield Hospital.
Example: Cheshire Hospital, Dartmouth Hitchcock, Brattleboro Memorial Hospital, Clinical Colleagues (anesthesia), and vRad (radiology). Services may be performed at Springfield Hospital that are not covered under our financial assistance program. Should you receive a bill from them, please call them and inquire about their programs.
Please note that financial assistance does not apply for ‘no shows’ for physician appointments.
HOW TO APPLY FOR ASSISTANCE
Applications can be obtained at each community health center location, or you can request an application by mail by calling 802-886-8959 ext. 1506, or Valley Health Connections at 802-885-1616. A personal appointment can expedite the eligibility determination process.
SMCS offers a prompt pay discount in accordance with the following schedule:
a. 25% if the full payment is made within 30 calendar days form the date of the first bill.
b. 15% if the full payment is made within 40 days from the date of the first bill.
c. 5% if the full payment is made within 50 calendar days from the date of the first bill.
For assistance with the application process, please contact:
Valley Health Connections
Patient Financial Counselor
Monday – Friday (8 am – 4 pm)
802-886-8959, ext. 1506