PAYMENT

Be prepared to pay any co-pay or deductible amounts on the day services are rendered. Patients who do not have insurance coverage or those having non-emergent services are required to pay their co-pay or deductible on the date of service. Please contact our financial counselor 502-732-3258 for information on making payment arrangements.

FINANCIAL ASSISTANCE

We realize that at times you may require special financial arrangements. In these instances, please call our financial counselor at (502) 732-3258 prior to your scheduled day or service to discuss alternative methods of payment. Our patient account representatives are available 8 a.m. to 4:30 p.m. Monday through Friday to discuss financial arrangements with you. Carroll County Memorial Hospital accepts cash, cashier’s checks, all major credit cards and personal checks with a valid I.D.

Who is eligible for this financial assistance?

You may qualify for free or discounted emergency or medically necessary care if you meet all of the following criteria:
1. You do not have health insurance, or you have an unpaid balance after your insurance plan has either paid or rejected a claim.
2. You do not qualify for subsidized coverage or government assistance, such as Disproportionate Share Hospital Program, Children’s Health Insurance Program (CHIP), Medicaid, and Medicaid Managed Care Organization.
3. Your family unit’s income is equal to or less than 100 percent of the federal poverty guidelines.
4. Your family unit’s resources (assets) are equal to or less than 100 percent of the Disproportionate Share Hospital guidelines.
5. For additional financial assistance criteria, please refer to the Carroll County Memorial Hospital Financial Assistance Policy.

What will I be charged for care?

Carroll County Memorial Hospital provides hospital-based emergency and other medically necessary care free of charge to all patients who meet the criteria for the Charity Care Policy. Patients who are eligible for financial assistance will not be charged more than the amounts generally billed to patients with insurance coverage. This includes care at Carroll County Memorial Hospital, Bedford Family Practice and Warsaw Family Practice locations.

How do I apply for assistance?

To apply for financial assistance, you must submit a written application. You will have to provide a copy of your previous three months of income by one of the following documents: bank statements, check stubs or award letter.

You also can pick up an application at Carroll County Memorial Hospital

You can download and print an application using the following links:

When you complete the paper application you can drop it off at one of the locations listed above or mail it to:

Carroll County Memorial Hospital
Attention: Financial Counselor
309 11th Street
Carrollton, KY 41008