FINANCIAL ASSISTANCE POLICY

CMH offers financial assistance, under its Financial Assistance Policy, to eligible patients unable to pay for medically necessary care. Eligibility for financial assistance is based on several factors including insurance coverage or other sources of payment, income, family size, assets and any special considerations the patient would like to have considered. Patients seeking financial assistance must comply with the Financial Assistance application process, including submitting tax returns, bank statements, pay stubs, as well as completing the application process for all available sources of assistance, including Medicaid.

The patient or any person involved in the care of the patient can express financial concerns at any point during the patient's care. The patient will then complete the financial assistance application, which can be submitted at any time prior to the account receiving a court judgement. Any information submitted will be treated as protected health information under the Health Insurance Portability and Accountability Act (HIPPA).

Financial Assistance Application Form
Financial Assistance Policy - Plain Language
Financial Assistance Policy

For more information, please contact Shelly Day at (785) 562-4450.

Entities and Providers COVERED by CMH Financial Assistance Policy

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Entities EXCLUDED from CMH Financial Assistance Policy

Click HERE for full list

Rev. 12/01/2018