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
833-263-9783
For additional information about the financial assistance policy or an application form, view the documents below:
Arabic
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Chinese - Simplified
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Chinese - Traditional
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
English
- Amount Generally Billed
- Billing and Collection Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
German
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Hindi
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Japanese
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Korean
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Russian
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish
Spanish
- Amount Generally Billed
- Billing and Collections Practices
- Financial Assistance Application
- Financial Assistance Secondary Application (Ascension St. Joseph’s and Standish Hospitals ONLY)
- Financial Assistance Policy
- Financial Assistance Program Summary
- Providers Covered by Financial Assistance Policy - Ascension St. Mary's
- Providers Covered by Financial Assistance Policy - Ascension Standish