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
844-931-1162

For additional information about the financial assistance policy or an application form, view the documents below:

Amount Generally Billed Calculation

Financial assistance application

Financial assistance policy

Plain language summary of the financial assistance policy

Physicians covered and no by financial assistance policy

To assist you in determining whether your physician of emergency or medically necessary care is covered by Ascension Illinois’s Financial Assistance Policy, please select the document below.