How to apply for Hospital Financial Assistance (Roger Mills Memorial Hospital) — Roger Mills in Oklahoma

Who it's for

Roger Mills Memorial Hospital in Cheyenne, a critical access hospital, has a charity application for patients who cannot pay their hospital bill. The hospital reviews each application against your household size, income and assets and approves or denies it in writing. Attach a copy of your most recent tax return, proof of all sources of income, and a copy of your denial letter from the Oklahoma Health Care Authority (SoonerCare). The hospital does not publish income limits, so call the Business Office at 580-497-3336 to ask how much help is available. Mail the application to Roger Mills Memorial Hospital, PO Box 219, Cheyenne, OK 73628, or bring it to 501 South L.L. Males Avenue.

What you'll need

• Charity Application / Financial Statement
• Copy of your most recent tax return
• Copies and verification of all sources of income
• Copy of the denial from your Oklahoma Health Care Authority (SoonerCare) application

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Roger Mills Memorial Hospital) — Roger Mills. 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 charity Application / Financial Statement, copy of your most recent tax return, copies and verification of all sources of income — 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)