Financial Assistance

CITIZENS MEDICAL CENTER

Financial Assistance Policy - Plain Language Summary

 

The Citizens Medical Center Financial Assistance Policy exists to provide eligible patients partially discounted emergent or medically-necessary hospital care. Patients seeking financial assistance must apply for the program, which is summarized below.

Eligible Services - Patients receiving eligible services must submit a Financial Assistance Questionnaire (including related documentation/information). Determination of eligibility results from a review of the submitted information by the Patient Financial Advisor, Billing Office Manager, and Chief Financial Officer. Elective care is not covered by financial assistance and is the responsibility of the patient at 100% of charges.

How To Apply - The Financial Assistance Questionnaire may be obtained, completed, and submitted as follows:

  • Obtain an application at Citizens Medical Center's Admissions desk or at the office of the Patient Financial Advisor.
  • Request to have an application mailed to you by calling (785)460-4872.
  • Request an application by mail at Citizens Medical Center, 100 East College Drive, Colby, KS 67701
  • Download the policy and  questionnaire , Addendum (1)  here.
  • Obtain information about the financial assistance program from the Thomas County Health Department in Colby.

Determination of Financial Assistance Elegibility - Generally, patients are eligible for financial assistance based on their income level and assets. Patients with family income of 100% of the Federal Poverty Level or less may be eligible for a discount of 90%. Patients with family income of over 100% of the Federal Poverty Level may be eligible for a discount ranging from 10% to 80%. Eligible patients will not be charged more for emergency or other medically necessary care than Amounts Generally Billed (AGB) to those patients who have insurance

Financial Assistance Brochure