{"hospital":{"ccn":"101304","name":"CALHOUN-LIBERTY HOSPITAL","city":"BLOUNTSTOWN","state":"FL","zip":"32424","phone":"850-674-5411","ownership":"Voluntary non-profit - Private","website_domain":"calhounlibertyhospital.com","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"100","layer":"documented","quote":"Patients whose family income is in the range of 0-100% of the Annual FPG are eligible to receive a discount of 100%.","source_id":"fap-9ec0b02fd5737db1","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"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":["tax_return","bank_statements"],"layer":"documented","quote":"Include an application process, in which the patient, the patient’s guarantor or supporting person/persons are required to cooperate and supply personal, financial and other information and documentation relevant to making a determination of financial need (such as but not limited to tax returns, bank statements, proof of assets etc.).","source_id":"fap-e426b7666575930c","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Physical/Mailing Address: Calhoun-Liberty Hospital 20370 NE Burns Avenue Blountstown, FL 32424"},{"kind":"fax","detail":"Fax: 850-237-3011"},{"kind":"in_person","detail":"Visiting our Business Office which is open Monday through Friday from 8:00am to 4:30pm CST"}],"layer":"documented","quote":"How to Apply for Financial Assistance: To apply for financial assistance, please submit a complete Financial Assistance Application with the required supporting documents to the address or fax below. Physical/Mailing Address: Fax: Calhoun-Liberty Hospital 850-237-3011 Attention: Financial Counselor 20370 NE Burns Avenue Blountstown, FL 32424","source_id":"fap-9ec0b02fd5737db1","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"window_days_from_first_bill":null,"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"850-237-3025","layer":"documented","quote":"Calling 850-237-3025","source_id":"fap-9ec0b02fd5737db1","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"hours":{"value":"Monday through Friday from 8:00am to 4:30pm CST","layer":"documented","quote":"Visiting our Business Office which is open Monday through Friday from 8:00am to 4:30pm CST","source_id":"fap-9ec0b02fd5737db1","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-9ec0b02fd5737db1","kind":"hospital_web","url":"https://www.calhounlibertyhospital.com/wp-content/uploads/2023/03/Financial-Assistance-Policy-2023.pdf","title":"SUBJECT: FINANCIAL ASSISTANCE PAGE: 1 DEPARTMENT","fetched_on":"2026-10-10","sha256":"9ec0b02fd5737db108b589d84a5abd79de93f8a7df2d7e37d62de71b59616bb3","effective_date":null},{"id":"fap-e426b7666575930c","kind":"hospital_web","url":"https://www.calhounlibertyhospital.com/wp-content/uploads/2013/08/Hospital-Financial-Assistance-Policy.pdf","title":"1 Policy and/or Procedure: Financial Assistance ...","fetched_on":"2026-10-10","sha256":"e426b7666575930c7e2adf43cc50b4ee49a8d7824acb78c539c44d387df3825d","effective_date":null}],"accuracy":null}