Helping Hands Financial Assistance

Financial Assistance may be available to patients who do not qualify for state or federal assistance.

INTEGRIS Community Hospitals recognize there are times when patients may have difficulty paying for services received. Financial Assistance may be available to patients who do not qualify for state or federal assistance. In most cases, patients that fall between 0-150% of Federal Poverty Guidelines based on total household income may have a 100% Financial Assistance discount processed (subject to income verification/documentation requirements). In certain cases, other discounts ranging from 62-90% may apply if the patient’s total household income exceeds these thresholds. Further eligibility and assistance information, a copy of our financial assistance policy, the Financial Assistance application form and a plain language summary of the Financial Assistance policy (English or Spanish) are available by contacting the INTEGRIS Community Hospital Customer Service Department at 877-516-0911, Option 1.

 

Who is Eligible for Financial Assistance?

Financial assistance is generally determined by your total household income as compared to the Federal Poverty Level. Patients with family incomes less than or equal to 150% of the Federal Poverty Level are eligible for a 100% charity care write-off of the portion of the charges for which you are responsible. Patients with family incomes ranging from 151% to 300% of the Federal Poverty Level, are eligible for discounted rates on a sliding scale. To qualify for financial assistance, patients must complete a financial assistance application, provide requested documents to verify financial need and meet other eligibility criteria. Patients who are eligible for financial assistance will not be charged more for eligible care than the amounts generally billed to patients who have insurance coverage covering such care. You may be asked if you have insurance of any kind to help pay for care. You may be asked to show that insurance or a government program will not pay for care.

 

What Services Are Covered?

Financial Assistance is only available to emergency and other medically necessary care. These terms are defined in the Financial Assistance Policy. Elective services are not covered by the Financial Assistance Policy.

 

How Can I Apply?

You must apply for financial assistance by completing a written application and providing requested supporting documentation, as described in the Financial Assistance Policy and the Financial Assistance Policy application. The Financial Assistance Policy application instructions will be made available upon patient request at the time of service.

If a patient wishes to apply for financial assistance after the medical services have been provided, the Financial Assistance Policy application instructions may be accessed and printed directly from this page.

Patients may also request a copy of the Financial Assistance Policy application instructions by mail. To request a copy of the documents by mail, patients can contact the Customer Service Department at 877-516-0911, Option 1.

 

How Can I Get Help with an Application?

For help with a Financial Assistance Policy application, you may contact:

INTEGRIS Community Hospital Customer Service
877-516-0911, Option 1

After the application has been reviewed, a determination of eligibility or non-eligibility will be made and you will be notified of the decision.

 

How Can I Get More Information?

Copies of the Financial Assistance Policy and application form are available at the links in the table below and at any INTEGRIS Community Hospital location. Free copies of the Financial Assistance Policy and application can also be obtained by mail when contacting the Customer Service Department at 877-516-0911, Option 1.

Downloadable Forms

Click an item on in the table below to access a downloadable file in .PDF format. Hard copies of the Financial Assistance Policy and application are available at the INTEGRIS Community Hospital locations and can also be obtained by mail when calling the Customer Service department at 877-516-0911, Option 1.

Financial Assistance Documents

Mailing Address Contact Number Plain Language Summary Financial Assistance Policy Financial Assistance Application Patient Billing and Collections Policy
INTEGRIS Community Hospital – Council Crossing INTEGRIS Community Hospital – Council Crossing – Central Billing Office

Attn: Customer Service Department
8686 New Trails Drive
The Woodlands, TX 77381

1-877-516-0911
Option 1
English
Spanish
Vietnamese
English
Spanish
Vietnamese
English
Spanish
Vietnamese
English
Spanish
Vietnamese
INTEGRIS Community Hospital – Del City INTEGRIS Community Hospital – Del City – Central Billing Office

Attn: Customer Service Department
8686 New Trails Drive
The Woodlands, TX 77381

1-877-516-0911
Option 1
English
Spanish
Vietnamese
English
Spanish
Vietnamese
English
Spanish
Vietnamese
English
Spanish
Vietnamese
INTEGRIS Community Hospital – Moore INTEGRIS Community Hospital – Moore – Central Billing Office

Attn: Customer Service Department
8686 New Trails Drive
The Woodlands, TX 77381

1-877-516-0911
Option 1
English
Spanish
Vietnamese
English
Spanish
Vietnamese
English
Spanish
Vietnamese
English
Spanish
Vietnamese