4A (Expenses $ 28341647 including grants of $ 177) (Revenue $ 38488071)
ASPIRUS IRON RIVER HOSPITAL (AIR) PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL AND PHYSICIAN CLINIC SERVICES. IN 2021, AIR HAD 481 INPATIENT ADMISSIONS AND 1,442 INPATIENT DAYS ALONG WITH 6,931 EMERGENCY DEPARTMENT VISITS WITH AN EMERGENCY PROVIDER STAFFED 24/7. AIR HAS 2 PROVIDER CLINICS, ONE ON THE HOSPITAL CAMPUS AND ONE LOCATED 15 MILES AWAY IN CRYSTAL FALLS, MI., BOTH PROVIDED 20,368 PATIENT VISITS IN 2021. THE HOSPITAL ALSO PROVIDES ICU SERVICES ALONG WITH A SWING BED PROGRAM. THE HOSPITAL ALSO HAS FULLY FUNCTIONING LAB AND RADIOLOGY DEPARTMENTS THAT ARE SUPPLEMENTED BY A MOBILE MRI UNIT THAT VISITS THE HOSPITAL CAMPUS BIWEEKLY. BOTH IP AND OP SURGERIES ARE PERFORMED WITH TOTAL OR CASES OF 757 IN 2021. BECAUSE OF REGIONAL AFFILIATION, AIR IS ALSO ABLE TO PROVIDE ORTHOPEDIC, OB CLINIC VISITS, CARDIOLOGY, BEHAVIORAL HEALTH, AND ONCOLOGY SERVICES.

ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
PART V, SECTION B, LINE 3J: IMPLEMENTATION STRATEGY AND BUDGET PROJECTIONS.

ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
PART V, SECTION B, LINE 5: DATA FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE GATHERED FROM A WIDE ARRAY OF PUBLISHED SOURCES AND FROM A SURVEY OF 3,500 ADULTS IN THE 15 COUNTY REGION. EXTERNAL, OR SECONDARY, DATA SOURCES INCLUDE THE US CENSUS BUREAU AND ITS AMERICAN COMMUNITY SURVEY, AS WELL AS STATISTICS COMPILED BY THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE FEDERAL CENTERS FOR DISEASE CONTROL AND PREVENTION, AND OTHER GOVERNMENT AND PRIVATE AGENCIES. THE UPPER PENINSULA ASPIRUS HOSPITALS COLLABORATED WITH THE WESTERN U.P. HEALTH DEPARTMENT AS THE HEALTH DEPARTMENT RECEIVED A GRANT FROM THE MICHIGAN HEALTH ENDOWMENT FUND TO CONDUCT THE UPPER PENINSULA HEALTH ISSUES AND PRIORITIES SURVEY (2021 UPCHIPS). ASPIRUS DID NOT PAY ANY CONSULTANTS OR VENDORS.

ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
PART V, SECTION B, LINE 6A: ASPIRUS KEWEENAW HOSPITAL, ASPIRUS IRONWOOD HOSPITAL AND ASPIRUS ONTONAGON HOSPITAL

ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
PART V, SECTION B, LINE 6B: ALL OF THE ASPIRUS UPPER PENINSULA HOSPITALS INCLUDING ASPIRUS IRON RIVER COLLABORATED WITH THE WESTERN U.P. HEALTH DEPARTMENT AS THE HEALTH DEPARTMENT RECEIVED A GRANT FROM THE MICHIGAN HEALTH ENDOWMENT FUND TO CONDUCT THE UPPER PENINSULA COMMUNITY HEALTH ISSUES AND PRIORITIES SURVEY (2021 UPCHIPS).

ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
PART V, SECTION B, LINE 11: USING A SET OF CATEGORIES AND THE DATA WITHIN, ASPIRUS IRON RIVER, ALONG WITH THE OTHER 3 ASPIRUS UPPER MICHIGAN HOSPITALS, IDENTIFIED THREE MAJOR PRIORITY AREAS THAT IMPACT EACH OF THE UPPER PENINSULA COUNTIES AND IRON COUNTY, WI. FOR THE PURPOSES OF THE ASPIRUS IRON RIVER CHNA, AND TO FULFILL THE REQUIREMENTS SET FORTH BY THE PPACA, ASPIRUS IRON RIVER HAS TAKEN THE THREE OVERALL PRIORITIES AND WILL BE ADDRESSING THESE NEEDS AND LOOKING TO MAKE AN IMPACT ON THE FUTURE OF OUR COMMUNITIES. THE THREE MAJOR PRIORITY AREAS THAT WILL BE THE FOCUS ARE:1. MENTAL HEALTH ASPIRUS HOSPITALS IN THE U.P. PLAN TO ADDRESS MENTAL HEALTH THROUGH PREVENTION TRAININGS, ANTI-STIGMA CAMPAIGN, SENIOR WELLNESS PROGRAM, AND SUPPORT GROUPS THROUGH COLLABORATION WITH SEVERAL LOCAL MENTAL HEALTH AGENCIES AND RECOVERY CENTERS.2. SUBSTANCE ABUSE THE FOLLOWING STRATEGIES ARE PLANNED: EDUCATION AND OUTREACH, SELF-REFERRAL PROCESS, SUPPORT GROUPS, PROVISION OF SUBOXONE, AND PEER RECOVERY COACHING. PLANNED COLLABORATION WITH SEVERAL LOCAL MENTAL HEALTH AGENCIES AND RECOVERY CENTERS WILL ASSIST WITH THE PLAN.3. CHRONIC DISEASES - STRATEGIES ARE PLANNED FOR PREVENTION, PROMOTION, AND TREATMENT. PREVENTION/PROMOTION WILL INCLUDE FITNESS FACILITIES AND CLASSES, OUTREACH INCLUDING SCHOOLS, FOOD GLEANING, VERTICAL GARDENS, AND FOOD AS MEDICINE PROGRAM. TREATMENT WILL INCLUDE REFERRAL-BASED FITNESS PROGRAM, SUPPORT GROUPS (I.E., DIABETES), AND FRUIT AND VEGETABLE PRESCRIPTION PROGRAM.BASED ON THE CHNA, THE FOLLOWING ARE THE OTHER IDENTIFIED ISSUES NOT BEING ADDRESSED AND THE ASSOCIATED REASONS WHY: 1. HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE. 2. LACK OF HEALTH INSURANCE ASPIRUS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE THE AVAILABILITY AND AFFORDABILITY OF HEALTH INSURANCE, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE.3. UNEMPLOYMENT, WAGES, AND ECONOMIC CONDITIONS ASPIRUS WORKS TO PAY FAIR WAGES AND PROVIDE REASONABLE BENEFITS PACKAGES. ASPIRUS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE ECONOMIC CONDITIONS, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE.

ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY.

PART I, LINE 3C:
THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF THE FOLLOWING (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY): PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION. SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS AND IRREVOCABLE BURIAL TRUST FUNDS. TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE.

PART I, LINE 7:
THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSE, LESS MEDICAID PROVIDER TAXES DIVIDED BY GROSS PATIENT SERVICE REVENUES. THIS COST TO CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE ORGANIZATION. THE ORGANIZATION ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITABLE CARE POLICY. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED OR UNDERINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE ORGANIZATION.

PART I, LN 7 COL(F):
IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7 BAD DEBT EXPENSE OF $749,513 WAS EXCLUDED FROM THE DENOMINATOR.

PART III, LINE 2:
THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. THE COSTING METHODOLOGY USED WAS THE PATIENT CARE COST TO CHARGE RATIO WHICH WAS DERIVED FROM THE CALCULATION ON IRS WORKSHEET 2.

PART III, LINE 3:
THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS.

PART II, LINE 8:
ASPIRUS IRON RIVER EMPLOYEES CONTRIBUTED IN-KIND TIME TO CONDUCT MOCK INTERVIEWS FOR GRADUATING SENIORS AT THE LOCAL HIGH SCHOOL. HEALTH IS IMPACTED BY MANY SOCIAL AND ECONOMIC FACTORS, INCLUDING EDUCATION AND INCOME. BY SUPPORTING YOUTH IN THEIR PURSUIT OF GAINFUL EMPLOYMENT, ASPIRUS IS SUPPORTING EDUCATION AND GAINFUL EMPLOYMENT (WHICH CAN IMPACT HEALTH).

PART III, LINE 8:
THE AMOUNT OF MEDICARE ALLOWABLE COSTS WAS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES TO MEDICARE BENEFICIARIES, THESE PATIENTS, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. THE TOTAL MEDICARE REVENUE SHOWN ON SCHEDULE H IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY THE CHARGES FROM MEDICARE PROGRAM BENEFICIARIES THAT ARE REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THE AMOUNT LISTED FOR MEDICARE REVENUE DOES NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, PHYSICIAN SERVICES PROVIDED AT THE OUTLYING CLINIC LOCATIONS, AND A SIGNIFICANT PORTION OF LAB SERVICES WHICH ARE REIMBURSED BY THE MEDICARE PROGRAM UNDER ANOTHER METHODOLOGY. PHYSICIAN COVERAGE AND OUTPATIENT LAB SERVICES ARE REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT ASPIRUS IRON RIVER HOSPITAL PROVIDES TO THE COMMUNITY AND THE SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE OVERALL AVERAGE COST TO CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE DIVIDED BY THE HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED BASED ON MEDICARE REGULATIONS. INCLUDING THE FEE SCHEDULE ITEMS, SUCH AS PHYSICIAN SERVICES, WOULD PRODUCE A LARGER LOSS OR SHORTFALL ON THESE SERVICES TO BE REPORTED ON THE FORM 990 IN ANY GIVEN YEAR.

PART III, LINE 9B:
UPON A PATIENT'S APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENT'S ACCOUNT WITH AN EFFECTIVE AND TERMINATION DATE TO ASSURE CAPTURING ALL CHARGES FOR THE PATIENT FOR ADJUSTMENT IN A WORK QUEUE PRIOR TO ANY REMAINING BALANCE BEING MOVED TO PATIENT LIABILITY AND THEREFORE PREVENTING UNDISCOUNTED SERVICES FROM BEING BILLED TO A PATIENT.

PART VI, LINE 2:
ASPIRUS IRON RIVER HOSPITAL & CLINICS USES HEALTH AND SOCIAL DATA AND TRENDS FOR THE SAME TO DETERMINE POSSIBLE UNMET NEEDS WITH THE COMMUNITY IT SERVES. IT ALSO USES ITS TEAM MEMBERS' INVOLVEMENT IN COMMUNITY EVENTS TO USE AS A THERMOMETER FOR WHAT IS NEEDED.

PART VI, LINE 4:
ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. SERVES THE GREATER IRON COUNTY OF MI ALONG WITH COUNTIES OF NORTHERN WI. IRON COUNTY HAS A POPULATION OF APPROXIMATELY 12,000 WITH 31.2% AGED OVER 65. THE MEDIAN HOUSEHOLD INCOME IS $44,183 WITH 14.2% OF THE POPULATION IN POVERTY. IN RELATION TO OTHER COMMUNITIES WITHIN THE STATE OF MI, IRON COUNTY AND THE UPPER PENINSULA AS A WHOLE HAS FEWER PEOPLE PER SQUARE MILE AND A MUCH LOWER POPULATION BASE TO DRAW FROM.

PART VI, LINE 5:
ASPIRUS IRON RIVER HAS A REGIONAL BOARD OF DIRECTORS THAT INCLUDES SEVERAL INDIVIDUALS FROM THE COMMUNITY WITH A FOCUS ON HAVING THEM BE INDEPENDENT (I.E., HAVING NO DIRECT TIES TO THE HOSPITAL SYSTEM). MEDICAL PRIVILEGES ARE EXTENDED TO ALL LOCAL, QUALIFIED PROVIDERS. THROUGH MANY OPPORTUNITIES IN THE COMMUNITIES THAT WE SERVE, INVESTMENTS ARE MADE BACK INTO THE COMMUNITY INCLUDING DONATIONS TO SUPPORT LOCAL, HEALTH INSPIRED ACTIVITIES ANNUALLY. THESE OPPORTUNITIES RELATE TO THE SCHOOLS, ELDERLY CARE SERVICES, AMERICAN CANCER SOCIETY, HEALTH SCREENING, AND OTHERS.

PART III, LINE 4:
THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES.BAD DEBT POLICY AND PROCEDURE:POLICY: I. ASPIRUS' FINANCIAL POLICY REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. II. FAILURE TO MEET THESE REQUIREMENTS IN ASPIRUS POLICY WILL RESULT IN THE ACCOUNT BEING CONSIDERED FOR BAD DEBT ONCE ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THE ACCOUNT WILL BE REMOVED FROM ACCOUNTS RECEIVABLE AND TURNED OVER TO AN OUTSIDE AGENCY OR LAW FIRM FOR COLLECTION. PRIOR TO THIS HAPPENING, THE FOLLOWING CRITERIA MUST BE MET: A. PATIENT FINANCIAL SERVICES STAFF WILL MAKE REASONABLE COLLECTION EFFORTS BY WAY OF: 1. MONTHLY STATEMENTS 2. COLLECTION LETTERS 3. COLLECTION PHONE CALLS III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS. IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE. V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE. PROCEDURE: VI. THE FINAL STEP IS TO SUBMIT THE ACCOUNT TO A COLLECTION AGENCY OR LAW FIRM. EACH ACCOUNT IS REVIEWED TO DETERMINE IF THE ACCOUNT HAS MET THE BAD DEBT CRITERIA. ONCE IT HAS BEEN DETERMINED THAT ALL REQUIREMENTS HAVE BEEN MET, THE ACCOUNT IS TRANSFERRED FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY THE FINANCIAL COUNSELOR. SPECIFIC PROCEDURES PERTAINING TO THE DETAILED PROCEDURAL STEPS FOR TRANSFERRING TO THE AGENCY CAN BE FOUND IN THE INTERNAL POLICY. A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS: 1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS. 2. THE HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS. 3. THE DEBT IS NOT COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE FIRST BILLING TO THE PATIENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. II. BAD DEBT RECOVERIES A. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. B. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. C. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE.

PART VI, LINE 3:
ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. CARDON OUTREACH IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS.

PART VI, LINE 6:
ASPIRUS IRON RIVER IS A PART OF THE ASPIRUS, INC. SYSTEM WITH THE MAIN BASE IN WAUSAU WI. TOGETHER WE PROMOTE THE MISSION AND WORK COLLABORATIVELY TO SHARE THE PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. THE COMBINED EFFORTS ARE ABLE TO PROVIDE THE SMALLER COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. ALSO, AS PART OF THIS SYSTEM ARE 3 OTHER UPPER PENINSULA OF MI HOSPITALS AND 11 OTHER HOSPITAL SYSTEMS IN WI ALONG WITH POST-ACUTE CARE PROGRAMS, MANY PROVIDER CLINICS, AMBULANCE SERVICE AND LONG-TERM CARE.

PART VI, LINE 7, REPORTS FILED WITH STATES
MI