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Financial Assistance & Payment Plans

Payment Plans

What if I cannot pay my bill in full? – At St. Elizabeth physicians we offer many payment options including payment plans. Please contact us if you are unable to make payment in full. Making less than a full payment without making prior arrangements may result in the transfer of your account to an outside collection agency.

Financial Hardship Program

St. Elizabeth Physicians is committed to providing financial assistance to those in need. Eligibility is based upon family size and current income. Print the Financial Hardship Application from our website. Our Financial Hardship Program is designed for:

  1. Individuals and families having a remaining balance after their insurance has processed a claim, or
  2. Individuals and families who are uninsured.

The goal of the Financial Hardship Program is to ensure that all individuals have the opportunity to receive medically necessary care, regardless of their ability to pay. If the patient’s family income is below 200% of the Federal Poverty Guidelines, this program may provide substantial relief from physician bills. To be eligible, patients must complete an application and provide the necessary documentation. For assistance with our Financial Hardship Program, please call (859) 344-5555 or toll-free at (877) 687-3303 Monday through Thursday 8:00 a.m. – 5:30 p.m. and Friday 8:00 a.m. – 4 p.m.

How to Apply for Financial Hardship

  1. Print the Financial Hardship Application from our website
  2. Pick one up at your physician’s office
  3. Call our customer service department at 859.344.5555 or toll-free at (877) 687.3303.

How do I turn in an application for Financial Hardship?

  1. You can mail in your application to St. Elizabeth Physicians Attn: FHA 2300 Chamber Center Dr. Ste 200 Ft. Mitchell, KY 41017
  2. You can fax your application to 859.795.5461
  3. You can email your application to sepcollections@stelizabeth.com
  4. You can turn in your application at any of our office locations.

Criteria for Financial Assistance

  • Before any financial hardship is granted, you must exhaust all other sources of payment including insurance.
  • Family income in relation to income guidelines
  • Patient must be a United States citizen or legal resident.

To determine if you are eligible for financial hardship, you must provide a completed financial hardship application along with copies of supporting income documents. Upon receipt, we will process your application and notify you of our determination within 30 days.

Charges from St. Elizabeth Healthcare or by other providers not within St. Elizabeth Physicians are not covered by the St. Elizabeth Physicians financial hardship program.

 

Proof of Income

  • If you are claiming that you have no income, please provide a notarized explanation of how you are obtaining food, housing, etc.
  • If you reside with someone who provides for you, you must submit their income information.
  • Three consecutive check stubs (including current employment, child support, unemployment, workers compensation, etc.).
  • Food stamp letter
  • Previous year’s tax return
  • Social security or disability benefit letter
  • If self-employed, a financial statement of gross income less business expenses on company letter head and notarized.
  • If you are a nursing home resident, please send proof of residency and power of attorney (POA) papers.

Notification

You will receive written notice of approval or denial once all documents are received for your financial hardship application. It takes approximately 30 days from the time we receive your completed application and supporting documents to process and mail you a determination letter. Incomplete applications will only delay the financial hardship application process. If you are denied, you will be responsible for payment in full. If you are unable to make full payment on your account, you can arrange a payment plan.

St. Elizabeth Physicians will not discriminate in the determination of financial hardship eligibility on the basis of race, color, ethnic origin, marital status, age or disability.

Discount to Self-Pay Patients who do not qualify for Financial Hardship

St. Elizabeth Physicians provides discounted pricing to uninsured patients who do not qualify for financial hardship assistance. The discount rate will remain in place for a 12 month period and will be reviewed each December for the following year. This discount is automatically applied at the time of billing to all accounts designated as “self-pay”.

When possible, financial counseling and discounted pricing will be discussed with patients prior to being seen. Charges from St. Elizabeth Healthcare or by other providers not within St. Elizabeth Physicians are not covered by the St. Elizabeth Physicians self-pay discount.

Assistance for Uninsured Patients

Our Financial Counselor utilizes a social service approach to assisting uninsured patients with securing insurance and/or funding through federal and state agencies (i.e. Department of Social Security, Medicare, Medicaid, Kynect, etc.). We can help the patient navigate the application process either by phone or in-person interviews.

If you are uninsured and wish to discuss your options for obtaining insurance, please call (859) 905-3961 or toll free at (855) 209-6394 Monday through Thursday 9:00 a.m. – 5:00 p.m. and Friday 9:00 a.m. – 4:00 p.m.

Uninsured Discount Program

For uninsured patients who do not qualify for either of the programs above or other discounts, we offer a self-pay discount for physician bills.

For questions regarding the self-pay discount, please call (859) 344-5555 or toll-free at (877) 687-3303 Monday through Thursday 8:00 a.m. – 5:30 p.m. and Friday 8:00 a.m. – 4 p.m.