How to apply for Hospital Financial Assistance (Saint Mary's Regional Medical Center) — Pope in Arkansas

Who it's for

Saint Mary's Regional Medical Center in Russellville has a Financial Assistance Program for patients who are uninsured (no health insurance and not eligible for Medicare, Medicaid or public assistance) or under-insured (insurance that does not cover the current bill). You must complete a Financial Assistance Application with at least two income documents. If approved, you sign an agreement to pay the reduced part of your bill in monthly installments. You can apply before your date of service and up to four months after. Call the hospital business office at 479-968-2841, 9 a.m. to 4 p.m., Monday through Friday.

What you'll need

• At least two of: most recent state or federal income tax return; employer pay stubs for the last two months; written documentation from income sources; copies of all bank statements for the last three months; current credit report (the hospital can obtain it with your authorization)

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Saint Mary's Regional Medical Center) — Pope. I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need at least two of: most recent state or federal income tax return; employer pay stubs for the last two months; written documentation from income sources; copies of all bank statements for the last three months; current credit report (the hospital can obtain it with your authorization) — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Renewals

annual (reapply per policy)