{"hospital":{"ccn":"140013","name":"CARLE HEALTH PROCTOR HOSPITAL","city":"PEORIA","state":"IL","zip":"61354","phone":"309-691-1000","ownership":"Voluntary non-profit - Private","website_domain":"carle.org","system":null},"version":3,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"0-200% of FPIG: 100% discount off AGB","source_id":"fap-b10d2e17617aa892","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"200","max_fpl_inclusive":"225","discount_percent":65},{"min_fpl_exclusive":"225","max_fpl_inclusive":"250","discount_percent":45},{"min_fpl_exclusive":"250","max_fpl_inclusive":"300","discount_percent":25},{"min_fpl_exclusive":"300","max_fpl_inclusive":"400","discount_percent":5}],"layer":"documented","quote":"0-200% of FPIG: 100% discount off AGB\n201-225% of FPIG: 65% discount off AGB\n226-250% of FPIG: 45% discount off AGB\n251-300% of FPIG: 25% discount off AGB\n301-400% of FPIG: 5% discount off AGB","source_id":"fap-b10d2e17617aa892","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"assistance_ceiling_fpl":null,"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Financial Assistance will be offered for eligible patients to cover patient responsibility for uninsured patients as well as patients with balances remaining after insurance payment.","source_id":"fap-b10d2e17617aa892","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_residency"],"layer":"documented","quote":"An IL CHWR Hospital may require an Uninsured Patient who is requesting an uninsured discount to certify the existence, or absence of, assets owned by the Uninsured Patient and to provide documentation of the value of such assets, except for Uninsured Patient’s primary residence;","source_id":"fap-b10d2e17617aa892","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Central Billing Office, ATTN: FA Team, P.O. Box 35758, Des Moines, IA 50315-4205"},{"kind":"email","detail":"FA_CBO_Request@unitypoint.org"},{"kind":"fax","detail":"(515) 362-5055"},{"kind":"in_person","detail":"submit to the hospital in person"}],"layer":"documented","quote":"Important: YOU MAY BE ABLE TO RECEIVE FREE OR DISCOUNTED CARE: Completing this application will help Carle Health – West Region determine if you can receive free or discounted services or other public programs that can help pay for your healthcare. Please submit this application in one of the following manners: If by mail, to the following address: Central Billing Office, ATTN: FA Team, P.O. Box 35758, Des Moines, IA 50315-4205 If by email, to FA_CBO_Request@unitypoint.org If by fax, to (515) 362-5055. Write “FA Application” on fax cover sheet. IF YOU ARE UNINSURED, A SOCIAL SECURITY NUMBER IS NOT REQUIRED TO QUALIFY FOR FREE OR DISCOUNTED CARE. However, a Social Security Number is required for some public programs, including Medicaid. Providing a Social Security Number is not required but will help the hospital determine whether you qualify for any public programs. Please complete this form and submit to the hospital in person, by mail, by electronic mail, or by fax to apply for free or discounted care within 60 days following the date of discharge or receipt of outpatient care.","source_id":"fap-b10d2e17617aa892","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":null,"hours":null,"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-4cbf7040e46e78f2","kind":"hospital_web","url":"https://dev.carle.org/X0873-eng","title":"Carle Financial Assistance Programs","fetched_on":"2026-10-10","sha256":"4cbf7040e46e78f2f2c649e3924596500277a247ce65e51202835a8da0eba52e","effective_date":null},{"id":"billing-e502db8b7f6fc3b3","kind":"hospital_web","url":"https://carle.org/patients-visitors/answers-to-billing-questions","title":"Answers to Frequently Asked Billing Questions - FAQs | Carle.org","fetched_on":"2026-10-10","sha256":"e502db8b7f6fc3b3981ed0b73f93e19b1a3eee57f49d25061f1867413d7d8070","effective_date":null},{"id":"fap-b10d2e17617aa892","kind":"hospital_web","url":"https://carle.org/getmedia/9e26c950-72c2-4b1f-9c81-433c1c9144c6/PeoriaFinancialAssistancePolicyEnglish-FINAL.pdf","title":"Title: Financial Assistance – Hospital Facilities 1.BR.34","fetched_on":"2026-10-10","sha256":"b10d2e17617aa8921dc19cbb76eaf81c2b20223f03b7aecf4cb71140370fd480","effective_date":null},{"id":"fap-bfcbef51a9f3799b","kind":"hospital_web","url":"https://carle.org/patients-visitors/financial-assistance","title":"Financial Assistance - Apply Today | Carle Health","fetched_on":"2026-10-10","sha256":"bfcbef51a9f3799b93bdc0d2e0cfdf6cbc7c3acea23cb2a71fe80de2e8813f37","effective_date":null},{"id":"fap-719bd70136e7d63d","kind":"hospital_web","url":"https://carle.org/patients-visitors/asistencia-financiera","title":"Financial Assistance en Espanol","fetched_on":"2026-10-10","sha256":"719bd70136e7d63d054a1d457658fa6a5d9f43918e234db68d8fac0829dd0b6f","effective_date":null},{"id":"fap-88cc9b03d3916937","kind":"hospital_web","url":"https://www.carle.org/getmedia/c9fd9222-41c0-4dfb-ba91-bb8dddb85d67/Carle-Rural-Health-Financial-Assistance-Program92625.pdf","title":"Carle Rural Health Financial Assistance Program","fetched_on":"2026-10-10","sha256":"88cc9b03d391693737af0e4d7130473c137df261ac29118507da02311992fdc2","effective_date":null}],"accuracy":null}