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Financial Assistance

Hospital Financial Assistance

CHI Health understands that paying for emergency and/or medically necessary medical care can be difficult, particularly for patients who lack health insurance. As part of our ongoing commitment to our patients, we work hard to help our patients address their financial responsibilities in a way that is fair and sensitive to their circumstances. We have instituted a program designed specifically to help those who find themselves in financial distress.

Our Financial Assistance Policy

Our Financial Assistance Policy (available in multiple languages) applies to uninsured/underinsured patients who come to our facilities for treatment. This policy provides financial relief to patients who qualify based on a comparison of their financial resources and/or income to Federal Poverty Guidelines. The program is designed specifically for emergent/urgent/ and/or medically necessary care patients whose household financial resources and/or income are at or below 400 percent of the Federal Poverty Level.

To qualify for any assistance, uninsured/underinsured patients will be asked to complete a Financial Assistance Application (available in multiple languages) which includes information relating to household income and expenses.

We are committed to working with our patients to establish an appropriate payment plan based on the amount due and the patient’s financial status.

Questions about Qualifying for Financial Assistance?

If you have any questions about qualifying or applying for financial assistance, please contact a representative for your hospital at the corresponding number below:

Creighton University Medical Center - Bergan Mercy, Creighton University Medical Center - University Campus, Immanuel, Lakeside, Lasting Hope Recovery Center, Mercy Council Bluffs, Mercy Corning, Midlands, Missouri Valley, Plainview, Schuyler, Good Samaritan, Nebraska Heart, Richard  Young Behavioral Health, St. Elizabeth, and St. Francis, St. Mary's:

Monday - Friday, 8:00 a.m. - 5:00 p.m.
Toll Free: (844) 286-5546
Fax: (469) 803-4627
E-mail: [email protected]

Language Access services are available 24 hours a day, 7 days a week at no charge.

CHI Health Mercy Corning

Please note: for CHI Health Mercy Corning there are specific financial applications and plain language summaries that differ from other CHI Health locations.

Addendum - Financial Assistance Policy Contact

Amount Generally Billed - If you qualify for partial support from CommonSpirit Health, learn the amounts generally billed/reimbursed for services at CommonSpirit Health hospitals.

We are committed to price transparency and empowering patients to understand their health care costs. Basic information about pricing and costs is provided below. For a more complete understanding of your financial responsibility, we encourage you to contact your insurance provider.

We want to help you make informed decisions about your care. To obtain cost estimates for common health care services, please access our easy-to-use cost estimator tool.  You may also contact our financial counselors for assistance.

Standard Charges

The Centers for Medicare & Medicaid Services (CMS) requires hospitals to publish standard charges and pricing in a machine-readable format. The Standard Charges file does not include insurance deductibles or other patient-specific insurance information or financial assistance discounts. To obtain an estimate of your out-of-pocket costs, we recommend using our cost estimator tool or contacting your insurance provider.

The following Standard Charges Machine Readable File is posted in a CMS-compliant .JSON file format. Per 45 CFR 180.20, Machine Readable File format means “a digital representation of data or information in a file that can be imported or read into a computer system for further processing. Examples of machine-readable formats include, but are not limited to, .XML, .JSON and .CSV formats.”  Because the files are intended to be read by machines for further processing, these files are not intended to be user-friendly. Please use our Cost Estimator Tool for access to user-friendly consumer pricing information on shoppable services.

Our hospital used the recommended format/schema provided by CMS for .JSON machine-readable file development. The detailed schema can be found here on the CMS Hospital Price Transparency Resources page.

Download our standard Charge Description Master (CDM) files below:

Download our Machine Readable Standard Charge Files (MRF) below: