Fill out the Financial Assistance Application Here
Be sure to check your eligibilty on the chart above. If you qualify, click the link to fill out the application.
Financial Assistance
No person is denied needed care because they can’t afford to pay. Schneck Medical Center's Financial Assistance Policy was established to identify and assist patients who lack the financial resources to meet all or part of their financial liability for services rendered and to determine their eligibility for Schneck-based financial assistance. See more detailed information and if you qualify below.
Schneck's policies allow fair discounts and protection to low income or uninsured patients and ensure consistent and fair collection practices.
Schneck publishes a financial assistance policy that is consistent with our mission and values and takes into account each patient's ability to contribute to the cost of his or her care and Schneck's financial ability to provide care.
Schneck conspicuously posts in all registration areas of the hospital the telephone number patients may call to obtain further information on Schneck's financial assistance policy.
The patient handbook includes information on Schneck's financial assistance policy.
Computerized billing statements include information on the financial assistance policy including contact information, telephone numbers, and an email address for any patient requesting assistance.
Use a consistent sliding fee scale for patient liability in assessing patient financial need. The ranges serve as a guide in offering financial assistance.
Provide extended payment plans with no interest charges to our low income and uninsured patients.
Assist patients in applying for state and/or federal financial aid programs for which they qualify.
Póliza de Asistencia Financiera
Resúmen de la Política de Asistencia Financiera
Providers Covered by the Financial Assistance Policy
Proveedores Cubiertos por la Póliza de Asistencia Financiera (FAP)
Amount Generally Billed Calculation
Calculación de la Cantidad Generalmente Enviada por Recibo
Credit and Collection Policy
Poliza de Credito y Cobranza
Financial Assistance Application Financial Assistance Application
Aplicación para Asistencia Financiera
For more information, please contact Patient Financial Services at (812) 522-0411 option 3.