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Financial Assistance Policy

Summary

If you cannot pay your bill, Providence Medical Center (PMC) has a 
Financial Assistance Policy that might be able to help if you qualify. 
Some ways you can qualify for help paying your hospital bill are:

  • If you don’t have insurance 
  • If you don’t have enough insurance
  • If you can’t get Medicaid
  • If you have lots of medical bills

 

What to do

  1. Read the Financial Assistance Policy and fill out the Financial Assistance application. 
    If the application is not filled out completely or we need more information we will notify you.

     
  2. Return the application along with the most recent copy of your W-2 form,
    tax return, bank statement, and past the 3 months of pay stubs. 
    All the information you give us will be kept private.

 

What will happen

Your application will be looked over and we will mail you our decision.    
These are the things we will be looking at:

  • How many people are in your family
  • How much money you make
  • What you own
  • How much you spend each month for living
     

Any patient who receives financial assistance may not be charged more than
the amount generally billed for emergency or medically necessary care. 
This means that if you qualify for financial help we cannot bill you more
than we would bill an insurance company.

If you have any questions, please call the financial help line at 402-375-7670, 402-375-3800, or 844-883-3496.

Financial Assistance Billing and Collections Policy.pdf (Full Version)
Providence Medical Center Financial Assistance Application- English2016.pdf
Providence Medical Center Financial Assistance Application- Spanish2016.pdf
 
 

 

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