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Financial Assistance Policy | Financial Assistance Application | Billing Policy | AGB | Summary of Financial Assistance Policy | List of Support Documentation
Ascension St. Vincent’s has a commitment to and respect for each person’s dignity with a special concern for those who struggle with barriers to access healthcare services. Ascension St. Vincent’s has an equal commitment to manage its healthcare resources as a service to the entire community. In furtherance of these principles, Ascension St. Vincent’s provides financial assistance for certain individuals who receive emergency or other medically necessary care from Ascension St. Vincent’s. This summary provides a brief overview of Ascension St. Vincent’s Financial Assistance Policy.
Who Is Eligible?
You may be able to get financial assistance. Financial assistance is generally determined by your total household income as compared to the Federal Poverty Level. If your income is less than or equal to 250% of the Federal Poverty Level, you will receive a 100% charity care write-off on the portion of the charges for which you are responsible. If your income is above 250% of the Federal Poverty Level but does not exceed 400% of the Federal Poverty Level, you may receive discounted rates on a sliding scale. Patients who are eligible for financial assistance will not be charged more for eligible care than the amounts generally billed to patients with insurance coverage.
What Services Are Covered?
The Financial Assistance Policy applies to emergency and other medically necessary care. These terms are defined in the Financial Assistance Policy. Elective services are not covered by the Financial Assistance Policy.
How Can I Apply?
Once efforts to confirm coverage availability have been exhausted, Ascension St. Vincent’s uses a predictive model to provide a systematic method to grant presumptive financial assistance to patients with appropriate financial needs. You may also apply for financial assistance. In such a case, you typically will complete a written application and provide supporting documentation, as described in the Financial Assistance Policy and the Financial Assistance Policy application.
How Can I Get Help with an Application?
For help with a Financial Assistance Policy application, you may contact:
Financial Counselor Office
How Can I Get More Information?
Copies of the Financial Assistance Policy and Financial Assistance Policy application form are available at www.stvhs.com and at the Business Office or Cashier Office at any facility. Free copies of the Financial Assistance Policy and Financial Assistance Policy application also can be obtained by mail by contacting a Financial Counselor by phone or in person at the Business Office of the hospital or by contacting Customer Service @ 877-202-0356. Additional information about the Financial Assistance Policy also is available by email at firstname.lastname@example.org or by telephone at 205-274-3048.
What If I Am Not Eligible?
If you do not qualify for financial assistance under the Financial Assistance Policy, you may qualify for other types of assistance. For more information, please contact:
Financial Counselor Office