{"hospital":{"ccn":"100319","name":"ADVENTHEALTH WESLEY CHAPEL","city":"WESLEY CHAPEL","state":"FL","zip":"33544","phone":"813-929-5000","ownership":"Voluntary non-profit - Private","website_domain":"adventhealth.com","system":null},"version":2,"status":"published","eligibility":{"free_care_max_fpl":{"value":"250","layer":"documented","quote":"To be eligible for a one hundred percent (100%) reduction on applicable balances (i.e. full write-off for uninsured patients and full write-off of the patient responsibility portion of balances after insurance) the individual’s household income must be at or below two hundred fifty percent (250%) of the current Federal Poverty Guidelines for the prior twelve (12) months or full year preceding the date of service or the date a Financial Assistance Application is submitted, whichever is later.","source_id":"fap-849172864f0b3d8d","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":{"value":true,"layer":"documented","quote":"In addition to evaluation of income level outlined above, an asset means test may also be applied to Medicare recipients only.","source_id":"fap-849172864f0b3d8d","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"residency":null,"insured_patients_covered":null,"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income"],"layer":"documented","quote":"Proof of income (POI) may be required from the individual.","source_id":"fap-849172864f0b3d8d","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Identification of Potentially Eligible Individuals. Requests for financial assistance will be honored up to two hundred forty (240) days after the date of the first post-discharge billing statement, sent by mail or electronically to the patient, for the care provided.","source_id":"fap-849172864f0b3d8d","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"decision_days":{"value":60,"layer":"documented","quote":"▪ 及时以书面形式通知个人，一般在收到填妥的经济援助申请表后的六十 （60）天内，通知其资格认定结果和认定依据。","source_id":"fap-ed42d666e01769b7","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"One hundred twenty (120) days from the date the entity provides the first post-discharge billing statement for the care provided, AdventHealth may engage in ECAs including but not limited to selling debt to a third party (see section D of this policy for more information regarding debt sale) only after the following notifications have been provided to the individual at least thirty (30) days before initiating any ECAs:","source_id":"fap-849172864f0b3d8d","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":null,"hours":null,"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-1c102478d8c675dc","kind":"hospital_web","url":"https://www.adventhealth.com/hospital/adventhealth-orlando/legal/financial-assistance","title":"Financial Assistance | AdventHealth Orlando","fetched_on":"2026-10-09","sha256":"1c102478d8c675dce6d2dbf33d2eea5d8ac549b7d3322c9dbf1899a11c540489","effective_date":null},{"id":"fap-82f9ea3dd06480ac","kind":"hospital_web","url":"https://www.adventhealth.com/sites/default/files/assets/adventhealth_financial_assistance_packet-2025_greek_0.pdf","title":"View PDF","fetched_on":"2026-10-09","sha256":"82f9ea3dd06480ac8baaff564a6787ae6501f5719e80005269cc91b2870f4ff2","effective_date":null},{"id":"fap-849172864f0b3d8d","kind":"hospital_web","url":"https://www.adventhealth.com/sites/default/files/assets/cw-f-50.1-financial-assistance-05282026.pdf","title":"View PDF","fetched_on":"2026-10-09","sha256":"849172864f0b3d8d562b8631d6773b9b1e4e964e71953797204dd3f33f357548","effective_date":null},{"id":"fap-ed42d666e01769b7","kind":"hospital_web","url":"https://www.adventhealth.com/sites/default/files/assets/adventhealth_financial_assistance_packet-2025_chinese.pdf","title":"View PDF","fetched_on":"2026-10-09","sha256":"ed42d666e01769b748a60bc3577f414071f8f1703dbab24085bd7082959db706","effective_date":null},{"id":"fap-ed4fd4f9a2ec7211","kind":"hospital_web","url":"https://www.adventhealth.com/sites/default/files/assets/adventhealth_financial_assistance_packet-2025_arabic.pdf","title":"View PDF","fetched_on":"2026-10-09","sha256":"ed4fd4f9a2ec7211a89ade123299f7e10517da41ba6e73c0d1974b845ecb4165","effective_date":null}],"accuracy":null}