Washington Health System Greene is committed to providing health care services to all. In situations where a patient is uninsured, we have a financial counselor available to help. There are several options available to help patients receive insurance coverage. We even have Certified Application Counselors (CAC’s) available to help navigate the Affordable Care Act insurance exchange. In cases where these options fall short, Charity Care may also be an option. For your convenience please complete the attached Charity Care Application.
Please complete the Charity Care application in its entirety and return to the hospital within 10 days along with all requested documentation.
You will be notified by mail of our determination of your eligibility. If you have any questions concerning this application or any other financial questions concerning your bill please feel free to contact us at 724.627.2733. As always we thank you for choosing Washington Health System Greene to meet your healthcare needs.
Please enclose the following with your application:
- Fully Completed Charity Application
- Denial Notice from the Medical Assistance Office (Must complete application by providing all necessary information to the Medical Assistance office. Incomplete applications will not be considered for Charity care)
- Copy of your last 3 months of Bank Statements
- Copy of your most Recent Tax Return (if applicable)
- Current Proof of Income for All Persons over the age of 18 that are being claimed as dependents on your IRS tax return.
(Example: Copies Pay Stubs, Social Security Statements, Unemployment Notification Letters, VA Statements, Proof of Retirement Income, child support etc.)
*** Must provide 3 months of Pay Stubs, if paid bi-weekly we will need seven Pay Stubs, if paid weekly we will need thirteen ***
For Assistance on how to complete the Application please call 724.627.2733 or 724.627.2669.