Financial Aid for Your Medical Group Bill
At Ascension hospitals and clinics, patients receive necessary medical care, regardless of their ability to pay. Services are provided without regard to culture, age, gender, sexual orientation, spiritual beliefs, socioeconomic status, language or disability. Trained financial counselors are available to discuss individual needs. We will review your eligibility for financial assistance and assist you in making payment arrangements.
If you feel you need financial assistance, please print and complete the financial assistance application form below:
Our mailing address for completed forms:
Ascension Medical Group
P.O. Box 80278
Indianapolis IN 46240
Additional income, asset and expense information may be requested upon review of the completed financial assistance application.
Financial counselors are available Monday through Friday 8 am – 4:30 pm. For additional assistance please contact a counselor associated to the location where services were performed.
Contact Us
Hours
Monday-Friday
8 am-4:30 pm
Ascension Medical Group
844-994-0410
For additional information about the financial assistance policy or an application form, view the documents below:
English
- Financial Assistance Policy
- Financial Assistance Application
- Billing Policy
- Amount Generally Billed Calculation
- Summary of Financial Assistance Policy
- List of Providers Covered by the Financial Assistance Policy
Spanish
- Política de asistencia financiera
- Formulario de aplicación
- Politica de facturación y cobro
- Calculo de la suma facturada normalmente
- Resumen de la Política de Asistencia Financiera
- Lista de Proveedores Cubiertos por La Política de Ayuda Financiera
Simplified Chinese
Traditional Chinese