Have questions?
Contact Patient Financial Services at
(541) 789-4111
or
(888) 608-7632
Financial assistance application
English (pdf)
Spanish (pdf)
Asante financial assistance policy plain language summary
English(pdf)
Spanish (pdf)
Financial assistance policy
English(pdf)
Spanish (pdf)
Financial assistance appeal
English (pdf)
Spanish (pdf)
Financial assistance
Asante is dedicated to making health care services accessible to our patients. We recognize the financial needs of patients and families who are not able to afford medical care. For those who qualify, financial assistance discounts may help with medically necessary services.
Eligibility and assistance offered
To qualify for free or discounted care, the patient or family must be determined eligible through either presumptive screening or through the completion of a Financial Assistance Application.
Eligibility is based on the US government's Federal Poverty Level guidelines, published annually. Asante uses family's household annual income and family size to determine a patient's Federal Poverty Level and level of free or discounted care.
Payment options
Asante also offers several different payment plan options. The duration of a payment plan is based on patient balance. You may call Patient Financial Services at (541) 789-4111, option 2 to discuss payment plan options.
Application process
A patient may apply for financial assistance any time up to 240 days following the first billing statement for services provided, or up to 12 months after the patient paid for services provided. You will receive a letter by mail within 10 days of Patient Financial Services receiving the application regarding your eligibility.
Applications can be submitted to our Patient Financial Services office at P.O. Box 4749 Medford, OR 97501, or through your Asante MyChart portal.
A financial assistance eligible patient will not be charged more than the Amounts Generally Billed (AGB). More information about AGB is described in the Financial Assistance Policy.
Additional discounts and payment options are described in Asante’s Financial Assistance Policy, a copy of which can obtain as described below.
Calculation of free or discounted care
Program
|
Available to
|
Description
|
How to apply
|
|
Financial Assistance
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All eligible patients based on household size and income
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Free or discounted services based on patient FPL. Discounts range from 25% to 100% for patients with an FPL of 400% or less.
|
Awarded through either presumptive screening or completed Financial Assistance Program Application.
|
|
Uninsured
|
Uninsured Patients Only
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Reduction of 35% or AGB (amounts generally billed).
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None.
|
|
Financial Assistance–Catastrophic
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Uninsured Patients Only
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Limits out-of-pocket costs when medical debts specific to medical care at hospital exceed 25% of the family's gross income.
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Complete the Financial Assistance Program Application.
|
|
Payment Plan Program
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Uninsured and Insured Patients
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Assists patients with their financial obligations by establishing payment arrangements.
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Contact Patient Financial Services at (541) 789-4111.
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