Financial Assistance Program and Collection Policy Financial Assistance Program and Collection Policy.pdf
PROGRAMA DE ASISTENCIA FINANCIERA Y POLIZA DE COBRANZA
Policy – Plain Language Summary Updated.pdf
Resumen en Lenguaje Sencillo de la Póliza de Asistencia Financiera
Federal Poverty Levels – Appendix A.pdf
Providers and Groups covered by FAP – APPENDIX B.pdf
Providers and Groups Not covered by FAP – APPENDIX C.pdf
Financial Assistance Application – Public Assistance.pdf
Estado Financiero Personal Para Asistencia Financiera.pdf
“Great Plains of Cheyenne County, Inc. DBA Cheyenne County Hospital, Cheyenne County Clinic, and Cheyenne County Health Department will not discriminate based on a patient’s inability to pay for health care services or because payment for healthcare services will be made under Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). There is a discounted/sliding fee schedule available based on family size and income. No patient will be denied access to services due to inability to pay.
Great Plains of Cheyenne County, Inc. dba Cheyenne County Hospital, Cheyenne County Clinic, and Cheyenne County Health Department tienen disponible un programa de Asistencia Financiera . Por favor acuda a la Oficina en Cheyenne County Hospital para obtener informacio´n. En adicio´n, Cheyenne County Clinic ofrece el programa de Escala de Tarifa Variable para aquellos que califiquen . A ningún paciente se le negarán los servicios por no poder pagar.
