CLEVELAND CLINIC MARTIN NORTH HOSPITAL

"At or below 100% of poverty level 100% discount 101% to 250%of poverty level 100% discount"

documented · checked 2026-10-11 · CHARITY CARE PLAN - FINANCIAL ASSISTANCE POLICY

"A financial statement (maintained in Patient Accounts) will be sent to the legally responsible person to be completed and returned with proof of income and expenses."

documented · checked 2026-10-11 · CHARITY CARE PLAN - FINANCIAL ASSISTANCE POLICY

"Reasonable efforts to determine eligibility include: notification to the patient by Cleveland Clinic Mercy Hospital of the Policy upon admission and in written and oral communications with the patient regarding the patient’s bill, an effort to notify the individual by telephone about the Policy and the process for applying for assistance at least 30 days before taking action to initiate any lawsuit, and a written response to any Financial Assistance Application for assistance under this Policy submitted within 240 days of the first billing statement with respect to the unpaid balance or, if later, the date on which a collection agency working on behalf of the Cleveland Clinic returns the unpaid balance to the Clinic."

documented · checked 2026-10-11 · CHARITY CARE PLAN - FINANCIAL ASSISTANCE POLICY

"Patients will receive a series of up to four billing statements over a 120-day period beginning after the patient has been discharged delivered to the address on record for the patient."

documented · checked 2026-10-11 · CHARITY CARE PLAN - FINANCIAL ASSISTANCE POLICY

"Patients can apply for assistance by calling 330-580-4739 and speaking with a Financial Counselor. More details on programs available or a list of locations can be obtained at https://my.clevelandclinic.org/locations/mercy-hospital or call 330-489-7150. Patients can also meet with a Financial Counselor at Cleveland Clinic Mercy Hospital 1320 Mercy Dr. N.W. Canton, Ohio. Contact our Business Office at 330-489-1145 for information regarding eligibility or the programs that may be available to you, to request a copy of the FAP, FAP application form to be mailed to you, or if you need a copy of the FAP or FAP application form."

documented · checked 2026-10-11 · CHARITY CARE PLAN - FINANCIAL ASSISTANCE POLICY