{"hospital":{"ccn":"141315","name":"ILLINI COMMUNITY HOSPITAL","city":"PITTSFIELD","state":"IL","zip":"62363","phone":"217-285-2113","ownership":"Voluntary non-profit - Private","website_domain":"blessinghealth.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"275","layer":"documented","quote":"Patient has reported income below 275% of the Federal Poverty Income Guidelines at any Blessing location.","source_id":"fap-46bd3962d80d49cd","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":null,"assistance_ceiling_fpl":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":["proof_of_income","social_security_letter","tax_return","pay_stubs"],"layer":"documented","quote":"Copy of your most recent filed Federal 1040 Income Tax Return including all schedules, W-2 Statements, and 1099 forms. If you did not file a Return for the most recent filing period, your application must include an explanation of the reason why no Return was filed. • Forms advising status of unemployment, worker's compensation, or Medicaid • Copy of most recent paycheck stubs from all jobs held in the current year showing year to date earnings in the absence of income, a letter of support and/or a declaration of no income from the patient and/or responsible party detailing how the individual's current living needs are being met • Proof of all income such as Social Security, unemployment, disability, pensions, child support, alimony or foster care. • Other information that Blessing may deem relevant in assisting Blessing entities in making the most appropriate financial determination","source_id":"fap-46bd3962d80d49cd","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":""},{"kind":"fax","detail":""},{"kind":"in_person","detail":""}],"layer":"documented","quote":"Please complete this application and submit with the requested documentation to the hospital in person, by mail, or by fax to apply for free or discounted care.","source_id":"application-02292ca8c2e9c6b4","checked_on":"2026-10-13","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":"(855) 354-5896 or (217) 277-3512","layer":"documented","quote":"Questions or Concerns If you have questions or concerns, you may contact Blessing Health System Patient Financial Services by calling (855) 354-5896 or (217) 277-3512.","source_id":"application-02292ca8c2e9c6b4","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":{"value":["Illini Community Hospital 640 West Washington Street | Pittsfield, IL"],"layer":"documented","quote":"Illini Community Hospital 640 West Washington Street | Pittsfield, IL","source_id":"application-02292ca8c2e9c6b4","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-46bd3962d80d49cd","kind":"hospital_web","url":"https://blessinghealth.org/sites/default/files/users/user15/Financial_Assistance_Policy_02-2025.pdf","title":"Financial Assistance - blessinghealth.org","fetched_on":"2026-10-13","sha256":"46bd3962d80d49cd22e0d0ebc66c6224d9e67951a4bd3b978741fcc1cf10df60","effective_date":null},{"id":"application-cf74bd0dcae21461","kind":"hospital_web","url":"https://www.blessinghealth.org/sites/default/files/users/user15/FOR_PATIENTS_Financial_Assistance_App_7-2023.pdf","title":"[PDF] Blessing Financial Assistance Application","fetched_on":"2026-10-13","sha256":"cf74bd0dcae21461cd5300b355966a83fe0c6c7cefb73ca784c4d0c757b7651d","effective_date":null},{"id":"summary-f7350e58edf8103a","kind":"hospital_web","url":"https://www.blessinghealth.org/sites/default/files/users/user15/FINANCIAL_ASSISTANCE_Plain_Language_Summary_9_23.pdf","title":"[PDF] ASKING FOR HELP TO PAY A BLESSING HEALTH SYSTEM ...","fetched_on":"2026-10-13","sha256":"f7350e58edf8103a4b69f0f223e2ba0ba58ddbc8c9e489ffaac3bc12ec435fa5","effective_date":null},{"id":"application-02292ca8c2e9c6b4","kind":"hospital_web","url":"https://www.blessinghealth.org/sites/default/files/users/user15/PATIENT_FINANCIAL_Financial_Assistance_Brochure_May_2025.pdf","title":"Blessing Health Center Financial Assistance Application","fetched_on":"2026-10-13","sha256":"02292ca8c2e9c6b4ee043f7343a27adb4a96814ecfa16f46b2040f44bcc1dce1","effective_date":null}],"accuracy":null}