← Patient Financial Services


Ivin­son Memo­r­ial Hospi­tal finan­cial assis­tance program is designed to assist patients who may not have the abil­ity to pay their hospi­tal bill(s). The level of assis­tance provided is based on a review of an individual’s economic condi­tion which includes income level and assets held. 

Upon request, an appli­ca­tion and a list of required finan­cial docu­men­ta­tion will be provided. This infor­ma­tion is neces­sary to deter­mine the patient’s abil­ity to pay. Both the completed appli­ca­tion and all required finan­cial docu­men­ta­tion must be returned in order to be consid­ered for finan­cial assis­tance. Please be aware of the due date on your application. 

Accounts must be in good stand­ing. There­fore, any accounts at collec­tion status more than six months are not eligi­ble for finan­cial assis­tance. Accounts for outpa­tient services, qual­ity of life proce­dures, elec­tive proce­dures or any other non-emer­gent proce­dures are only eligi­ble for our stan­dard payment plans. These accounts do not qual­ify for finan­cial assis­tance. Payments are required to keep your account(s) current during the appli­ca­tion process. Please include a payment with your returned appli­ca­tion as a sign of good faith. NOTE: Any account under $500.00 will NOT qual­ify for finan­cial assistance. 

The appli­ca­tion is only for charges with Ivin­son Memo­r­ial Hospi­tal. The appli­ca­tion does NOT cover Advanced Medical Imag­ing, Anes­the­sia services, any billing from a doctor or surgeon or any entity other than Ivin­son Memo­r­ial Hospital. 

You may contact our Finan­cial Coun­selor or our recep­tion­ist to request an appli­ca­tion packet. We will need to verify your status as student or non-student to ensure the correct infor­ma­tion for required docu­men­ta­tion is included. 

financial assistance policy

Our current finan­cial assis­tance policy outlines this program. 

financial assistance application

Designed for patients who do not have the abil­ity to pay their hospi­tal bill(s).

student financial assistance application

The finan­cial assis­tance appli­ca­tion that is designed for students who are unable to pay their hospi­tal bill(s).