Financial Assistance Policy

Baptist Memorial Health Care is committed to treating all patients equally, with dignity, respect and compassion. We established a Financial Assistance Policy (política de asistencia financiera) to help patients with an established need for assistance in paying for emergency and medically necessary care and help to determine if they qualify for federal, state and local programs with health care coverage.

Financial assistance is amount the patient does not have to pay based on the patient’s family and financial situation. The discount amount is calculated as a percentage of charges. Baptist financial assistance only covers charges by Baptist facilities and providers.

The financial assistance policy applies to all of the Baptist-affiliated locations. This includes Baptist Memorial Hospitals, Baptist Trinity Home Health, Baptist Hospice, Baptist Home Medical Equipment, Baptist Medical Group physicians and clinic services.

To determine your eligibility, please complete a financial assistance application (solicitud de ayuda financiera) and provide all of the required personal and financial information. Return the form and supporting documentation to the facility where you received or are receiving care.

Approved Documentation

The following documents can be used to determine the family income. Documentation supporting the income of all family members must be provided.

  • Pay stubs for the last three (3) months
  • Income tax return for the previous year
  • W-2 form for the previous year
  • State/federal assistance documents
  • Bank statements for the last three (3) months
  • Legal documents including divorce decrees and/or child support and alimony

Please refer to the Financial Assistance Policy for all other details.

Financial Assistance Forms & Documents

Please read the entire Financial Assistance Policy document below before completing the application.

English

Financial Assistance Policy

Financial Assistance Application

Financial Assistance Policy for Professional Services

Hospital Financial Assistance Policy

Plain-language Summary of Financial Assistance Policy

Billing & Collection Guidelines

Self-pay Minimum Discounts

En español

Solicitud Asistencia Financiera

Política de Asistencia Financiera Para Servicios Profesionales

Resumen en Lenguaje Sencillo Política de Asistencia Financiera

Política de Asistencia Financiera

Directrices de Facturación y Cobro