Financial Assistance Policy Plain Language Summary
Financial Assistance for Emergency or other Medically Necessary Care at Wayne Memorial Hospital
If you are unable to pay your bill, please contact the Business Office at the telephone number or address listed below to see if you are eligible for financial assistance. Each patient’s need for financial assistance is evaluated according to the level of his/her household income, in light of relevant facts and circumstances, such as reported income, assets, liabilities, expenses, and other available resources. Free care is available to patients whose household income is 200% or below the federal poverty level. You can go to the website at http://aspe.hhs.gov/poverty/index.cfm for the current federal poverty guidelines published by the U.S. Department of Health and Human Services.
Paper copies of both the policy and the application are also available at any patient registration area or the Business Office and will be mailed free-of-charge to a patient upon request:
Requests by phone: 570-251-6580
Requests by mail: Wayne Memorial Hospital
Attn: Patient Account Manager
601 Park Street
Honesdale, PA 18431
Individuals may apply for financial assistance under the facility’s FAP by mailing a completed application, along with proof of household income, to the above address or by bringing the application and proof of household income to any patient registration area or the Business Office. Patients may also call or visit the above location to receive assistance with the application process.
In the case of emergency or other medically necessary care covered under the FAP, patients eligible under the hospital facility’s FAP may not be charged more than the amounts generally billed (AGB) to individuals who have insurance covering such care.
Services provided by these physician groups, are not covered under the hospital’s Financial Assistance Policy. They must be contacted directly for discussion pertaining to Financial Assistance.
- Professional Emergency Care (ER Physicians) – call 888-861-8740 for further details about their Billing processes pertaining to Financial Assistance.
- Foundation Radiology Group (Radiologists) – call 800-401-0913 for further details about their Billing processes pertaining to Financial Assistance.
- Wayne Memorial Community Health Centers – call 570-251-6641 for further details about the below listed provider types Billing processes pertaining to Financial Assistance.
- Primary Care Physicians
- Pediatric Care
- Dental Care
- Behavioral Health
- Women’s Health Care
- General Surgery
- Pulmonary & Sleep Medicine
- General & Interventional Cardiology
- Neurology Services
If you do not see a physician/physician practitioner group listed above, please contact the WMH Business Office at 570-251-6580 to verify whether or not that physician/physician group is covered under the WMH FAP.