Patient Resources

Financial relief may be available for eligible patients who have received medically necessary care, do not qualify for state or federal assistance or programs, and cannot pay their bills. This assistance typically applies to patients with household incomes at or below 300% of the Federal Poverty Level. Such patients may be granted a charity discount upon submitting adequate supporting documentation.

Patients with a family income at or below 300% of applicable poverty guidelines or those with family income above 300% of applicable federal poverty guidelines but with significant unpaid medical bills, may be eligible for financial assistance, if the patient lacks sufficient funds.

Before applying a charity discount, the hospital must verify that no portion of the patient’s medical services can be covered by any federal or state program (e.g., Medicare, Medicaid, Champus, Medicare secondary payer), private insurance, or other third-party payers. Charity discounts cannot be applied to accounts with outstanding payer liabilities.

In addition to fully completing the Financial Assistance Application, the most recent Federal Tax Return will be the preferred documentation. For Medicare beneficiaries, the preferred income documentation, in addition to the completed Financial Assistance Application, is the most recent year’s Federal Tax Return.  

If any patient/responsible party cannot provide their latest Federal Tax Return; they may provide two pieces of supporting documentation from the following list to satisfy the income verification requirement:

·        State Income Tax Return for the most current year

·        Most Recent Employer Pay Stubs

·        Written documentation from income sources

·        Copy of all bank statements for the last three months

·        Current credit report

To determine eligibility, please call us.