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Gadsden Regional Medical Center
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                      Financial Assistance Program


                      Financial Arrangements

                      At the time of your admission, you will be asked to present information on your health insurance. Insurance payments are estimated based on the information you provide and arrangements should be made prior to discharge for the portion of your bill that will not be paid by insurance, such as deductibles and co-payments. During your stay you may receive a visit from a financial counselor to answer any insurance questions you may have and to discuss payment options available to you.

                      Your daily room charge includes your room, general nursing services, meals, housekeeping, linens, building maintenance, telephone service, business office assistance, and medical-record fees.

                      Separate charges are made for the operating room, recovery room, intensive care, oxygen, laboratory tests, X-rays, medications, special equipment, treatment, or therapy. Physician fees are not included in your bill. Other physician services, such as radiology, pathology, or anesthesia services will be billed separately.

                      Your hospitalization insurance is a contract between you and your insurance company. While we will assist you in expediting your health claim, you are ultimately responsible for your account.

                      In most cases a final bill will not be ready at the time of your discharge because charges for treatment or medications administered during the 24 hours preceding discharge may not have been received by our Business Office. A final bill will be mailed to you after discharge. Please feel free to contact our Business Office at (256) 494-4513 or (256) 494-4808, if you have any questions regarding your bill, insurance coverage, or any difficulties you may anticipate in the financing of your hospitalization.

                      Financial Assistance Information

                      Many, if not all, Alabama hospitals have traditionally offered financial planning and assistance to patients.

                      Our hospital is committed to treating all patients regardless of their ability to pay and providing financial assistance to persons who have healthcare needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for their medical care based on their individual financial situation under our hospital's Financial Assistance Program. No patient will be denied financial assistance due to his or her race, religion, national origin or any other basis prohibited by law.

                      Financial relief may be available to patients who receive non-elective care, do not qualify for state or federal assistance, and are unable to pay a substantial portion of their balance, either directly or through a third-party payer source.

                      We offer a Charity Care Discount under our Financial Assistance Program to patients who qualify under our policy, based on multiples of the U.S. Federal Poverty Guidelines, which will be evaluated using certain financial criteria and supporting documentation to verify income provided by the patient. A patient may apply for the Charity Care Discount by filling out our Financial Assistance Program ("FAP") Application linked below and returning it to the hospital, along with any required documentation, at the time of service or any time after care is provided during the patient's billing cycle. Click here to download a copy of the U.S. Federal Poverty Guidelines.

                      Patients who do not qualify for our Charity Care Discount may still be eligible for financial relief under the hospital's Financial Assistance Program. Patients without insurance or any other third-party payer source, who are not eligible for government assistance or our hospital's Charity Care Discount, will receive a discount from the hospital's billed charges, referred to as the "Uninsured Discount." Additionally, a patient may also be eligible for a "Catastrophic Care Discount," in the event the patient's account exceeds a certain percentage of the patient's gross annual income.

                      We also provide eligibility screening services that can help identify the availability of resources to cover medical services, such as Medicaid.

                      Please contact the hospital's Customer Service, Patient Access Director or Financial Counselor for more information on the discounts and qualification requirements offered under the hospital's Financial Assistance Program or to learn about any other payment plans that may be available to you at the hospital.

                      • Download Financial Assistance Application
                      • Download Financial Assistance Application (Español)
                      • Form 4506-T, Request for Transcript of Tax Return

                      Gadsden Regional Medical Center

                      • 1007 Goodyear Ave
                      • Gadsden, AL 35903
                      • P: (256) 494-4000
                      • F: (256) 494-4474

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                      An AllianceHealth Oklahoma® hospital

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