{"hospital":{"ccn":"140158","name":"INSIGHT HOSPITAL AND MEDICAL CENTER CHICAGO","city":"CHICAGO","state":"IL","zip":"60616","phone":"312-567-2000","ownership":"Voluntary non-profit - Private","website_domain":"insightchicago.com","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Family Income at or below 200% of the Federal Poverty Level Guidelines: 3.\nA 100% discount for all charges will be provided for uninsured and underinsured Patients whose Family’s Income is at or below 200% of the most recent Federal Poverty Level Guidelines.","source_id":"fap-9594ab239799826d","checked_on":"2026-10-13","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":{"value":"https://insightchicago.com/wp-content/uploads/2023/07/Financial-Assistance-Application-Insight-Hospital-Medical-Center-Chicago.pdf","layer":"documented","quote":"[English Application for Financial Assistance](https://insightchicago.com/wp-content/uploads/2023/07/Financial-Assistance-Application-Insight-Hospital-Medical-Center-Chicago.pdf \"English Application for Financial Assistance\")","source_id":"fap-dd3df7e6b1b245ab","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["pay_stubs","tax_return"],"layer":"documented","quote":"Insight will list the supporting documentation such as payroll stubs, tax returns, and credit history required to apply for financial assistance in the FAP or FAP application.","source_id":"fap-9594ab239799826d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":""},{"kind":"email","detail":"FinancialCounselors@insightchicago.org"}],"layer":"documented","quote":"Please call 312.567.2147 or send an email to FinancialCounselors@insightchicago.org, for a price estimate or to find out if you qualify for financial assistance.","source_id":"fap-dd3df7e6b1b245ab","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Application Period begins the day that care is provide and ends the later of 240 days after the first post-discharge billing statement is provided to the patient or either:","source_id":"fap-9594ab239799826d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days":{"value":30,"layer":"documented","quote":"Insight will provide patients that submit an incomplete FAP application a written notice that describes the additional information and/or documentation that must be submitted within 30 days from the date of the written notice to complete the FAP application.","source_id":"fap-9594ab239799826d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"Insight will refrain from initiating ECA(s) until 120 days after providing patients the first post-discharge billing statement for the episode of care, including the most recent episodes of care for outstanding bills that are aggregated for billing to the patient.","source_id":"fap-9594ab239799826d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"312.567.2147","layer":"documented","quote":"Please call 312.567.2147 or send an email to FinancialCounselors@insightchicago.org, for a price estimate or to find out if you qualify for financial assistance.","source_id":"fap-dd3df7e6b1b245ab","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Spanish","Chinese","Polish"],"layer":"documented","quote":"Applications are available in multiple languages–English, Spanish, Chinese, and Polish.","source_id":"fap-dd3df7e6b1b245ab","checked_on":"2026-10-13","confidence":1.0,"support_count":0}},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-dd3df7e6b1b245ab","kind":"hospital_web","url":"https://insightchicago.com/financial-assistance","title":"Financial Assistance » INSIGHT Chicago","fetched_on":"2026-10-13","sha256":"dd3df7e6b1b245ab69cf9a57362b2831d29513beb57d9edd6522f827ef84a803","effective_date":null},{"id":"fap-9594ab239799826d","kind":"hospital_web","url":"https://insightchicago.com/wp-content/uploads/2023/06/2023-Financial-Assistance-to-Patients-1708.pdf","title":"English","fetched_on":"2026-10-13","sha256":"9594ab239799826d782f0e089e95a9912f0b86d69b93343e8b3fefcf83173fd5","effective_date":null},{"id":"fap-9f41120952ba8f05","kind":"hospital_web","url":"https://insightchicago.com/wp-content/uploads/2023/07/2023-Edits-Financial-Assistance-to-Patients-1708-Chinese.pdf","title":"Chinese","fetched_on":"2026-10-13","sha256":"9f41120952ba8f054b596a5a338d7e217fe6bc7342eada299c8be03b3e4a7972","effective_date":null},{"id":"fap-a18ad7ae92efcdc5","kind":"hospital_web","url":"https://insightchicago.com/wp-content/uploads/2023/06/2023-Edits-Financial-Assistance-to-Patients-1708-POLISH.pdf","title":"Polish","fetched_on":"2026-10-13","sha256":"a18ad7ae92efcdc5095d166dfb809381c71ff0c7ed0af11e39075f956171c736","effective_date":null}],"accuracy":null}