Lourdes was established by the Daughters of Charity in 1925 to serve the people of this area, especially those in need. Today, we continue our strong commitment to provide services to patients regardless of their ability to pay.
Patients and/or Guarantors are responsible for payment of bills for services provided by, and billed by Lourdes, part of Ascension. Lourdes has established the Patient Financial Assistance Program to help patients who meet the income guidelines established by Lourdes, part of Ascension. It can also be used to assist with any copays or deductibles of other programs. If we believe that you are eligible for any other program, we will assist you with exploring your options through the Health Insurance Exchange. This enables us to serve as many people as possible with our limited funds. This program is available to the extent Lourdes' resources allow.
A financial scale based on federal poverty level guidelines determines your eligibility for the Patient Financial Assistance Program. How much your Lourdes bill will be discounted depends on how your gross income compares with this financial scale.
If you are found eligible, your discount will apply to all charges generated by Lourdes, except for non-emergency services provided to patients with insurance who have been notified in writing that Lourdes does not participate in their insurance plan. Some services received at Lourdes are provided by private physician groups, such as the services of a Radiologist or Anesthesiologist, and are not covered because the bill you receive is not a Lourdes bill. A Lourdes Patient Financial Counselor will be happy to answer any questions and to help you clarify your charges - just call 607-584-5522.
To Apply for Lourdes Patient Financial Assistance Program
- Download and Complete the application (PDF)
Please include the names and dates of birth for all immediate household members.
- Mail the completed application and copies of required proofs to the address at the bottom of the application. We will contact you once your application has been reviewed. If your application is denied, you may appeal this decision to the Health Care Access Committee.
If you wish to speak with a financial counselor, please call 607-584-5522.
- You do not need to schedule an appointment to meet with a Financial Counselor. You are welcome to walk in anytime between 8:00 AM and 4:00 PM, Monday - Friday to receive assistance completing your PFAP application. Financial Counselors are available at four locations:
- Lourdes Hospital (First Floor), 169 Riverside Drive, Binghamton, NY
- Lourdes Oral Health, 219 Front Street, Binghamton, NY
- Lourdes Chenango Bridge, 17 Chenango Bridge Road, Binghamton, NY
- Lourdes Hope Dispensary, 477 State Street, Binghamton, NY
- It takes up to 30 days to process your PFAP application.
- Applications are processed in the order in which they are received.
- If we have questions about your application, we will call you.
- If we do not have all the information necessary to process your application, the application will be returned to you with a request to provide additional information.
- You will receive written notification regarding the outcome of your PFAP application.
- If you receive a denial letter, please feel free to contact our Financial Counseling department at 607-584-5522.
In accordance with our Mission and Values, Lourdes Hospital is committed to caring for all people regardless of their ability to pay, with special attention to those who are poor and vulnerable. Lourdes Hospital offers financial counseling and assistance to help address any financial concerns patients or families may have regarding their care. Our financial aid policies, which can be found here on our website or by visiting our Patient Financial Assistance office, located on the ground floor of Lourdes Hospital, reflect Lourdes Hospital's dedication to working together with our patients in a compassionate and caring manner to identify options for resolving their financial obligations. Help is available by contacting the Financial Assistance office at 607-584-5522, by emailing LourdesPFAP@Ascension.org, or in person at any of our facilities.
Note: Applications submitted via email will not be accepted
- Amount Generally Billed Calculation
- Financial Assistance Policy
- Financial Assistance Program Summary
- Financial Assistance Application
- List of Providers Covered by the Financial Assistance Policy
- Self-Employed Form
- Amount Generally Billed Calculation - Spanish
- Financial Assistance Policy - Spanish
- Financial Assistance Program Summary - Spanish
- Financial Assistance Application - Spanish
- List of Providers Covered by the Financial Assistance Policy - Spanish
- Amount Generally Billed Calculation - Chinese (Traditional)
- Financial Assistance Policy - Chinese (Traditional)
- Financial Assistance Program Summary - Chinese (Traditional)
- Financial Assistance Application - Chinese (Traditional)
- List of Providers Covered by the Financial Assistance Policy - Chinese (Traditional)
- Amount Generally Billed Calculation - Chinese (Simplified)
- Financial Assistance Policy - Chinese (Simplified)
- Financial Assistance Program Summary - Chinese (Simplified)
- Financial Assistance Application - Chinese (Simplified)
- List of Providers Covered by the Financial Assistance Policy - Chinese (Simplified)