Worried About Your Bill? We Can Help
Patient Payment Alternatives
If you have insurance, Fayette County Memorial Hospital bills your insurance carrier according to information provided at registration. Any balances left after your insurance company pays the hospital are your responsibility.
When paying any balance, you have the following options:
1. PAYMENT IN FULL
You can make payment through the following means:
• Personal Check
• Money Order
• VISA, Master Card, Discover Card, (Debit or Credit)
Send payments or make inquiries to:
Fayette County Memorial Hospital
1430 Columbus Avenue
Washington Court House, OH 43160
*Prompt Payment Incentive For uninsured patients, if payment is received within 14 days, FCMH will reduce the balance by 20% (15% for insured).
2. H.E.L.P. PATIENT LOANS
The HELP Patient Loan Program offers patients attractive payment options.
Guaranteed Line of Credit
If you have a source of income, you are automatically qualified.
Manageable monthly payments up to a 25 month term.
No Pre-Payment Penalties
You can always make double payments or pay-off your account early without interest or other penalties attached.
Future Hospital Bills
As future hospital bills arise, you can simply add them to your time payment account.
You will not be subject to a formal credit check. For most people, if you have a source of income…YOU QUALIFY!
3. 90 DAY INTEREST FREE LOAN
FCMH offers an in-house payment plan which is interest free if paid within 90 days.
Call a financial counselor today to take advantage of one of our loan programs.
4. FINANCIAL SUPPORT PROGRAMS
HOSPTIAL CARE ASSISTANCE PROGRAM (HCAP)
If your annual income is below the National Poverty Guidelines, Fayette County Memorial Hospital has a program that can help.
2013 Annual Federal Poverty Guidelines
Family Size Income Guidelines
For family units with more than 8 members, add $4,020.00 for each additional member.
COMMUNITY FINANCIAL ASSISTANCE PROGRAM (CFA)
Fayette County Memorial Hospital believes that a discount should be offered to all patients whose adjusted household income is equal to or less than 300% of the Federal Poverty guidelines.
Eligibility for CFA will be as follows:
•Determination of qualification for other programs such as Medicaid or HCAP
•Determination of liquid assets
•Determination of adjusted household income is equal to or less than 300% of the Federal Poverty Guidelines
1. How do I apply for the HCAP or CFA?
Your first step should be to contact one of our Financial Counselors. At that time, the Counselor will be able to review with you the required information needed for completion of your application.
2. What if I still cannot afford the balance of the claim after the CFA discount?
A payment plan may be set up for the remainder of the balance on the claim.
3. Can I also apply to the HCAP or CFA program for claims that are currently in Bad Debt?
Depending on the age of the account, the Financial Counselor will be able to assist you with these time frames.
4. What information is required for the application process?
◦Two (2) Bank Statements (CFA only)
◦Three (3) months income prior to date of service
PATIENT CONTACT INFORMATION
Your Street Address:
Your City, State & Zip:
Best Phone to Reach You:
Hospital Account Number(s), if known:
Fayette County Memorial Hospital
1430 Columbus Avenue, WCH, OH 43160
OUR CONTACT INFORMATION
FCMH Operator: (740) 335-1210
Brenda: (740) 333-2730
Phillip: (740) 333-2939
HELP Financial: (800) 752-9613
Billing Department: (740) 333-2725
Social Services: (740) 333-2945
Ohio Dept. of Job & Family Services: (740) 335-0350
*Call one of our helpful financial counselors to set up an appointment to talk about your options, or print out a copy of this information here, fill out the contact information section, circle the option that you would like more information on, mail it to the Hospital, and we’ll call you at the phone number provided.