Policies

Notice of Privacy Practices

Notice of Privacy - English 2021

Notice of Privacy Practices - Spanish 2021

Facilities and Practices covered by the Notice of Privacy Practice

Medical Records

Authorization for Release of Medical Information

Patient Request for Access to Health Information

Guidelines for Email

Financial Assistance Policies

Plain Language Summary

Erlanger Western Carolina Hospital and its facilities offer financial assistance, based on the current Federal Poverty Guidelines to uninsured patients and guarantors with an outstanding balance owed for medically necessary services.

• Patients or guarantors may be determined to be Presumptively Eligible for financial assistance based on eligibility for other specific state or federal programs.
• Information about available financial assistance, including our Financial Assistance Policy and Application are included in the links below.
• Patients can obtain a copy of these documents, at no cost, by sending a request to Erlanger Western Carolina Hospital, Financial Counseling Department, 3990 E. US Hwy 64 Alt., Murphy, NC 28906-8707 or in person at Erlanger Western Carolina Hospital.
• Our Financial Counselors can be reached at 828-835-3662; 828-835-7719, Monday – Friday from 8:30AM – 5:00PM to assist you with any additional questions.
• Patients approved for financial assistance under the Erlanger Western Carolina Hospital Financial Assistance Policy will be billed no more than the amount generally billed (AGB) to Medicare and our Private Health Insurers.

Erlanger Medical Group Clinic Patients

• Financial Assistance Policy
• Financial Assistance Application (Sliding Fee Discount Application)

Erlanger Western Carolina Hospital Patients

• Financial Assistance Policy
• Financial Assistance Application - English
• Financial Assistance Policy - Spanish  (Solicitud de Asistencia Financiera)

Billing and Collections Policy

Accessibility Policy

Notice of Program Accessibility for Disabled Policy

Patient Rights and Responsibilities

Patient Rights and Responsibilities - English

Patient Rights and Responsibilities - Spanish (Derechos y Responsabilidades del Paciente)

Reporting concerns

Your quality care and safety is important to us. If you have any unresolved complaints regarding patient care or safety issues, you may report your complaints by doing the following:

Report your complaints directly to the department director or the administrator on-call. Dial “0” on any hospital phone or call 828-837-8161 from an outside phone, and ask for the “Administrator On-call”.

You will receive a prompt response to your concern.

If your concerns cannot be resolved by Erlanger Western Carolina Hospital, you may report them to our accrediting body or the state agency listed below:

The patient has the right to directly contact the North Carolina Department of Health and Human Services (State Survey Agency) or DNV-GL Accreditation Services

NC Division of Health Services Regulation
Complaint Intake Unit
2711 Mail Service Center
Raleigh, NC 27699-2711
www.ncdhhs.gov/dhsr/ciu/complaintintake
Telephone:  1-800-624-3004

DNV-GL Accreditation Services
400 Techne Center Drive, Suite 100
Milford, OH  45150
Telephone: 866-496-9647
Fax: (513) 947-1250
Website:  www.dnvglhealthcare.com

For reporting compliance related issues:
Compliance Integrity Line:
877-849-8338

Division of Health Services Regulation 2711 Mail Services Center, Raleigh, North Carolina 27699-2701 Toll Free: 800-624-3004

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