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
833-263-9784
For additional information about the financial assistance policy or an application form, view the documents below:
Summary of Financial Assistance Policy
To better understand our Financial Assistance Policy, we have created a resource that discusses eligibility, how to apply, what financial help is available, calculating the amounts generally billed, and more. Select your preferred language from the options below.
Applying For Assistance
Select the Financial Assistance document in your preferred language from the options below. It is important that you read the instructions document in full before submitting your application, as incomplete applications cannot be approved.
English
Español
In cases where an eligible patient receives financial assistance of less than 100% of gross charges, the patient will not owe more than the Amount Generally Billed (AGB) to individuals who have insurance.
Physicians Covered by Financial Assistance Policy
To assist you in determining whether your physician of emergency or medically necessary care is covered by Ascension Borgess Hospital’s Financial Assistance Policy, please select the document below.
To read our comprehensive Financial Assistance Policy, please select your preferred language from the options below:
To read our Billing and Collection policy, please select the link below: