| Dear Patient:
The philosophy of OSF HealthCare is that
all people have a right to receive needed health care. Our doors are
open to persons of every faith and ethnic background regardless of their
ability to pay.
We provide help to patients in obtaining
payment from third parties such as Medicaid and Medicare. If you are
eligible for Medicaid, and you are not currently signed up, we can help
you apply.
We also offer charity assistance for
medically necessary healthcare services to persons who meet our
financial terms provided they submit the needed documents. OSF Charity
Assistance may be applied for when there is a balance still due on an
account after we have received payment from third party payers (like
Medicaid, Medicare or an insurance company) and you feel you cannot pay
the full balance.
The PDF form available through the link
below must be completed and signed by you. We use income guidelines
established by the U. S. Dept. of Health and Human Services to determine
if you are eligible for charity care. We do verify assets regarding your
eligibility. So, please provide all the information promptly so we may
try to help you as quickly as possible.
If you have any questions about OSF
Charity Assistance or any other offers of assistance, please call our
Patient Accounts office of the facility billing you between 8 a.m. and 4
p.m., Monday through Friday.
OSF HealthCare offers high quality
healthcare and we were pleased to provide that to your family. We look
forward to working with you further to make sure the financial aspects
of your care are handled in the same high quality way.
Sincerely,
The Sisters of the Third Order of St. Francis
Click below to download
or print the OSF Charity Assistance PDF form.
English Version
Spanish
Version
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