Financial Assistance Policy

 

Plain Language Summary of Financial Assistance Policy

Northern Montana Hospital’s policy is to provide necessary medical care at a reduced rate to those patients who have documented limited resources to pay at the facility’s usual and customary charges.  Those individuals whose income is less than 125% of the guidelines would be eligible for a financial assistance allowance.  The Hospital uses the federal poverty guidelines (FPG) located at http://aspe.hhs.gov/poverty to determine eligibility for financial assistance on emergency and medically necessary primary health care services.  Available assets may also be used to determine eligibility if family income exceeds 200% of the federal poverty guidelines.

Copies of the Financial Assistance Policy and application are available on line at (https://nmhcare.org/wp-content/uploads/2018/05/NMH-Financial-Assistance.pdf and https://nmhcare.org/wp-content/uploads/2015/06/NMHC-Financial-Assistance-Application.pdf).  Copies of these documents can also be requested by contacting the Hospital’s Business Services Director through any of the following methods:

The Hospital can provide copies of the Financial Assistance Policy and application by email, mail or fax.  All copies are provided free of charge.

The Hospital’s Business Services Director can answer questions and/or provide further information about the Financial Assistance Policy.  Completed financial assistance applications, including all required information and documentation may be submitted to the Business Services Director through the following methods:

  • Mail: “Attention: Business Services Director” PO Box 1231, Havre, MT  59501
  • In-person delivery: 20-13th Street West, Havre, MT 59501
  • Email: bisestaa@nmhcare.org
  • Fax: “Attention Business Services Director”, (406) 262-1626

If you would like assistance in completing a financial assistance application, you may contact Jessica Z at (406) 262-1793.

An individual who qualifies for financial assistance will not be required to pay more for emergency medical care and other medically necessary care than the amounts generally billed to individuals who have insurance covering such care.

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