C.R.S. § 25.5-3-502.5: Uniform application for discounted care.

(1) After completion of the screening conducted pursuant to section 25.5-3-502, a health-care facility shall request information from a patient to complete a uniform application for discounted care if:

(a) The health-care facility needs more information to make a determination of whether the patient has qualified or is likely to qualify for discounted care or the health-care facility's financial assistance program, including if the health-care facility's policy is to require an application prior to making a final determination; or

(b) The patient requests an application, unless the patient has no balance remaining after applying any discounts pursuant to section 25.5-3-503 or the health-care facility's financial assistance program.

(2) A health-care facility shall use the uniform application developed by the state department to complete the application required by this section.

(3) Upon completion and review of the application, a health-care facility shall:

(a) If the health-care facility determines that a patient is a qualified patient, provide the patient notice of the determination, the patient's identified federal poverty guideline percentage, and the patient's monthly installment maximum payment, as described in section 25.5-3-503;

(b) If the health-care facility determines that a patient is not a qualified patient, provide the patient notice of the determination, which, if applicable, may also include notice that the patient is eligible for the health-care facility's financial assistance program and the amount of any discount offered through that program, and shall provide either:

(I) An opportunity for the patient to appeal the determination in accordance with state department rules; or

(II) A statement that the patient has no balance due after applying any discounts from the health-care facility's financial assistance program; and

(c) If the health-care facility is certified by the state department as a presumptive eligibility site and determines that the patient is presumptively eligible for medical assistance, provide the patient notice of the determination and information on how the patient can enroll in public health-care coverage.