Financial Assistance

 

Financial Assistance for Patients

Catholic Health Initiatives (CHI) 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, CHI works 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.

The Program
The CHI 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 non-elective care patients whose household financial resources and/or income are at or below 300 percent of the Federal Poverty Level.

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

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.

If you have questions regarding our policy or applications(s), please contact one of our Customer Service Representatives at 701-456-4000.

Catholic Health Initiatives Financial Assistance Plain Language Summary (PLS):
Catholic Health Initiatives Financial Assistance Policy:
Catholic Health Initiatives Billing and Collection Policy:
Catholic Health Initiatives Financial Assistance Application:
 
Providers Subject to Financial Assistance Policy at CHI St. Alexius Health Dickinson:  CLICK HERE

 

Downloads

Financial Assistance Plain Language Summary English: Download
Financial Assistance Plain Language Summary Spanish: Download
Financial Assistance Policy English: Download
Financial Assistance Policy Spanish: Download
Financial Assistance Policy Chinese: Download
Financial Assistance Policy German: Download
Financial Assistance Policy Vietnamese: Download
Billing and Collection Policy English: Download
Billing and Collection Policy Spanish: Download
Billing and Collection Policy Chinese: Download
Billing and Collection Policy German: Download
Billing and Collection Policy Vietnamese: Download
Financial Assistance Application English: Download
Financial Assistance Application Spanish: Download
Providers subject to Financial Assistance Policy at CHI St. Alexius Health Dickinson: Download