Uninsured Prompt Pay Discount Policy - Gundersen Health System

within the patient financial system. Patients who have been classified as “Self-Pay” will automatically have
information about the uninsured discount printed on their billing statements.
Information on Gundersen Lutheran payment policies is posted in the patient registration areas of the institution
and from financial aid counselors throughout the organization, as well as the
corporate website www.gundluth.org. In addition, Gundersen Lutheran’s payment policies are
printed on the reverse of all Gundersen Lutheran clinic and hospital billing statements and are
available at any time upon patient request.
B. Applying the Discount
Gundersen Lutheran will provide an uninsured prompt pay discount to uninsured self-pay patients receiving
eligible services at all Gundersen Lutheran facilities. This discount will be applied upon notification to
Gundersen Lutheran Customer Financial Service by the patient or guarantor that they are requesting the
uninsured prompt pay discount, Gundersen Lutheran Customer Financial Services has confirmed that the patient
is an eligible uninsured self-pay patient and the balance, less the uninsured prompt pay discount amount, has
been paid in full.
Gundersen Lutheran Customer Financial Service may be contacted either by phone at 608-775-8660, or in
writing at Gundersen Lutheran, 1900 South Ave., Mailstop NCA3-01, Attention Customer Financial Services,
La Crosse, WI 54601.
The discount will be at least equal to the weighted average percentage discount offered to the three largest nonself-insured,
non-affiliated third party payers. The discount will be calculated annually at the end of the 1st
quarter of each calendar year and shall remain in effect until the end of the first quarter of the following
calendar year.
The uninsured prompt pay discount will be:
Balance Discount Rate Timeframe from the date of the first
statement for Payment in Full
Any balance 10% 31-90 calendar days
Up to $2500 15% 30 calendar days
$2,500.01-$9,999.99 20% 30 calendar days
$10,000 and greater 25% 30 calendar days
Patients may request the discount by contacting Gundersen Lutheran Customer Financial Services. The discount
may apply if the eligible patient qualifies for discounting under GL’s charity care policy.
An important element in offering the above discount is the patient’s prompt payment of the bill for the services
rendered, or the patient’s prompt arrangement with Gundersen Lutheran to make payment. The patient shall
remit payment in full within the time frame outlined in the above discount table to receive an uninsured prompt
pay discount.
If full payment is not made within the timeframe outlined in the above discount table, the account will continue
along the normal cycle of accounts receivable up to and including referral to the collection agency.
Patients have the right to appeal a denial of the uninsured prompt pay discount to the Manager of
Customer Financial Services at 608-775-8670, or in writing to Gundersen Lutheran, 1900 South Avenue, Mail
Stop NCA3-01, La Crosse, WI 54601.