Financial Assistance for Medical Care
Ballad Health recognizes that those on limited incomes sometimes need help paying their bills.
That’s why we offer financial assistance to qualifying patients who need help with emergency or other necessary medical care they receive from us. Patients who believe that they cannot afford to pay and that their care does not qualify for governmental assistance programs may qualify for Financial Assistance.
All patients will be treated for emergency medical conditions without discrimination and regardless of their eligibility for free or discounted care.
Eligibility for financial assistance
Your eligibility for Financial Assistance will be determined based on a review of your family’s income, assets and liabilities. Additional information may be requested that ultimately could affect the Hospital’s decision and eligibility for Financial Assistance may vary by program or the hospital facility where you received care.
You may submit an Application for Financial Assistance and supporting documentation to the Patient Financial Services Department.
Application for financial assistance
To find out if you qualify for financial assistance, you’ll find the eligibility criteria and other important information in the application linked below.
Application for Financial Assistance [PDF]
You can pick up an in print copy of this application in the Hospital’s emergency department or admissions department, or you can contact (888) 288-5174 for a free copy of the application by mail.
You can mail in your application and supporting documents to:
Ballad Health
Attn: Document Imaging
PO Box 746465
Atlanta, GA 30374
Fax: 980-443-3061
Alternatively, you can also give us your application in person at any Ballad Health facility. Please allow 30-45 days for review once a completed application has been received.
Financial assistance policies and Plain Language summary
The Financial Assistance Policy, the Financial Assistance Application, and this Plain Language Summary are available in English and Spanish.
- Financial Assistance Policy [PDF]
- Plain Language Summary [PDF]
- Ballad Financial Assistance Appeal [PDF]
En Español
Ballad Health reconce que puede haber necesidad de asistencia financiera para individuos que tienen ingresos limitados para pagar sus cuentas del hospital. La eligibilidad para asistencia financiera esta basada en el criterio establecido y la informacion contenida en esta solicitud.
- Política de Asistencia Financiera [PDF] – Español / Spanish
- Resumen en Términos Sencillos [PDF] – Español / Spanish
- Solicitud para Asistencia Financiera [PDF] – Español / Spanish
Guidelines and financial assistance documents
- Exhibit A – Limitation of Charges [PDF]
- Exhibit B – Provider Participation List [PDF]
- U.S. Federal Poverty Guidelines
- Ballad Credit and Collections Policy [PDF]
Charges will not exceed amounts generally billed
If you receive Financial Assistance that does not fully cover the cost of your emergency or medically necessary care, you will not be charged more than the amounts we generally bill patients who have insurance.
Need help?
If you have any questions or need help completing the application, please call (888) 288‑5174 between 8 a.m. and 4:30 p.m., Monday through Friday.