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RELEASE OF HEALTHCARE INFORMATION FORM

SERVICES FOR PATIENTS & FAMILIES

Elliot Hospital
Financial Assistance Programs*

Thank you for choosing Elliot Hospital to meet your healthcare needs. It is a privilege to be of service to you.

Elliot is proud of its long history of providing healthcare services to all members of our community and to helping those who are in need of help. Elliot is committed to the continued availability of financial assistance programs designed to relieve the financial burden of healthcare services for those who need it the most.

Programs

Charitable Care Program

The Charitable Care Program ensures that all individuals are able to receive medically necessary care at the Elliot Hospital regardless of their ability to pay. The program provides relief from financial liability to the Elliot Hospital if the patient’s income falls below 400% of the Federal Poverty Guidelines. Patients must complete an application to be qualified for assistance. The charitable care assistance can range from a patient having no financial obligation to some percentage of the outstanding balance. (Please see specific qualification guidelines.)

 

Hospital Access Plus

Hospital Access Plus extends discounted health care to that portion of the population that may not be able to access or afford insurance either individually or through their employer. The program provides a 15% discount for all self-pay patients that receive medically necessary care from the Elliot Hospital.  (Hospital Access Plus website)

 

Catastrophic Relief Program

A “Catastrophic Relief Pool” is available to provide substantial financial assistance to those patients who experience costly and extended episodes of care at the Hospital due to serious sickness or injury. The policy provides relief to uninsured patients whose financial responsibility to the Elliot Hospital exceeds $50,000 for any single episode of care.

 

If you feel you may qualify or have any questions about financial assistance that may be available to you, please contact an Elliot patient care representative at 663-2571 or visit our Patient Financial Services office in the main lobby of the hospital.

 

Elliot Hospital reserves the right to amend the policies and procedures set forth on this page in its sole and absolute discretion. The existence of these policies and procedures do not create any legal right for the benefit of any person. In short, while Elliot remains committed to helping those in need, it must reserve its right to adapt its policies and procedures as circumstances warrant. Elliot Hospital Patient Financial Services will make ultimate decisions regarding the application of these policies and procedures.


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