This past July, Deborah Mills went to the emergency room at Beaufort Memorial Hospital with a severe case of bronchitis.
A few months later, she returned for treatment of carotid-artery disease.
Both times, she says, she filled out the requisite paperwork to apply for indigent care, which would heavily subsidize her bill, if not cover it completely.
But about 10 months after that first visit, she says she's still waiting to hear if she qualified. And she recently was contacted by a collection agency questioning the status of a $13,800 bill she says she can't afford.
"I've got no insurance and no income," said Mills, 58. "I'm basically living off unemployment (checks)." She did say the collection agency has been polite and patient, willing to wait on the hospital's decision.
Her indigent-care application is one of 1,438 currently awaiting review at the hospital, according to Jeff White, its chief financial officer. That backlog is growing, he said.
White, who said the wait for an indigent-care decision is typically four months, said those awaiting such a ruling have received medical care.
"Our charity care has almost doubled in the last two-and-a-half, three years," he said. "It is increasing dramatically."
He blamed health-insurance costs and the slow economy for the rise.
"I think there's more uninsured people, and I think people have dropped their insurance because they can't afford to pay the premiums," he said.
Beaufort Memorial isn't the only local medical center providing indigent care that is overwhelmed with applications.
Carol Waggoner, director of the Good Neighbor Medical Clinic in Beaufort, said her staff is busy processing a stack of paperwork that grows higher each week.
"We offer patient screenings on Monday mornings, and the wait to be screened is two weeks long right now," she said. "The wait for a new patient appointment can be up to two months, and it's getting longer."
Her clinic provides primary care to the uninsured. She said that at the screenings, prospective patients are required to provide proof of residency in Beaufort County, photo identification, and documentation that their income does not exceed 200 percent of the federal poverty standard, about $12,000 a year.
Waggoner estimated there are 30,000 people in Beaufort County without health insurance.
At the Volunteers in Medicine clinic in Bluffton, office manager Laurie Shay said the wait to be screened as a qualified patient takes three to four weeks.
"Demand is very high," she said. "It's growing, and we only have a limited number of volunteers."
At Beaufort Memorial, only two full-time employees review the indigent-care applications, but White said it recently hired a third to help reduce the backlog.
"What we've tried to do is make people understand that we're processing their application as quickly as we possibly can," he said. "It's really not an easy process; we've got to follow proper protocols, and it does bog down."
As a nonprofit organization, Beaufort Memorial is the only hospital in Beaufort and Jasper counties offering patients the opportunity to apply for indigent care.
White said his hospital provided $23 million in free care in 2011. He said that figure has risen in recent years as the facility has attracted a growing number of the indigent population.
"Ten years ago, all the paperwork wasn't an issue," he said.
"But now we're the choice for health care for people from all over, because they can't get it anywhere else."