{"hospital":{"ccn":"141324","name":"FERRELL HOSPITAL COMMUNITY FOUNDATIONS","city":"ELDORADO","state":"IL","zip":"62930","phone":"618-273-3361","ownership":"Voluntary non-profit - Private","website_domain":"ferrellhospital.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"125","layer":"documented","quote":"Uninsured patients with incomes below 125% of the Federal Poverty Guideline qualify for free care.","source_id":"fap-411695974a4f3271","checked_on":"2026-10-11","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":{"value":["Homelessness","Deceased with no estate","Mental incapacitation with no one to act on patient's behalf","Incarceration in a penal institution","Affiliation with a religious order and vow of poverty","Patients who receive grant assistance for medical services","Women, Infants and Children Nutrition Program (WIC)","Supplemental Nutrition Assistance Program (SNAP)","Illinois Free Lunch and Breakfast Programs","IHDA's Rental Housing Support Program","Low Income Home Energy Assistance Program (LIHEAP)","Temporary Assistance for Needy Families (TANF)"],"layer":"documented","quote":"Patients who are Illinois residents falling under one or more of the presumptive eligibility criteria below shall be presumed eligible for 100% financial assistance without completion of a financial assistance application:  Homelessness;  Deceased with no estate;  Mental incapacitation with no one to act on patient's behalf;  Medicaid eligibility, but not on date of service or for non-covered service.  Incarceration in a penal institution;  Affiliation with a religious order and vow of poverty;  Patients who receive grant assistance for medical services;  Women, Infants and Children Nutrition Program (WIC);  Supplemental Nutrition Assistance Program (SNAP);  Illinois Free Lunch and Breakfast Programs;  IHDA's Rental Housing Support Program;  Low Income Home Energy Assistance Program (LIHEAP);  Temporary Assistance for Needy Families (TANF);  Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as a criterion for membership","source_id":"fap-411695974a4f3271","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","social_security_letter","tax_return","pay_stubs","bank_statements","other"],"layer":"documented","quote":"Unless an Illinois uninsured patient demonstrated presumptive eligibility, the following documents need to be provided to determine financial assistance eligibility:  Federal Tax Return with Schedules, W-2, and 1099 forms for the most recent filing period, plus proof of worker’s compensation for lost wages, disability income, and child support received or paid.  If applicant is unable to provide a complete copy of a Federal Tax Return for the most recent filing period, or the Tax Return indicates inaccurate information, or Family Income has significantly changed, the following documentation is required for all current Family Income: o Two most recent Paystubs or written income verification from all employers; o For self-employed applicants, two most recent paystubs and if a business owner, two most recent Business Checking Account Statements. o Social Security Award Letter; o Unemployment Award Letter; o VA Benefits Letter; and o Verification of the following  Disability Income;  Worker’s compensation for lost wages;  Rental Income;  Strike Benefits;  Public Assistance:  Alimony; and  Proof of Child Support received or paid.  If unemployed with no source of income, a signed statement explaining how the applicant pays for daily living expenses.","source_id":"fap-411695974a4f3271","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"in_person","detail":"In person to the Patient Financial Counselor"},{"kind":"fax","detail":"Fax to at Ferrell Hospital Community Foundation 618-273-2504 Attn: Patient Financial Counselor"},{"kind":"mail","detail":"By mail to: Ferrell Hospital Community Foundation / 1201 Pine Street / Eldorado, Il 62930 Attn: Financial Counselor"},{"kind":"email","detail":"By email to financialcounselor@ferrellhospital.org"}],"layer":"documented","quote":"Completed applications can be submitted as follows:\n\n* In person to the Patient Financial Counselor at Ferrell Hospital Community Foundation\n* By email to financialcounselor@ferrellhospital.org\n* By fax to 618-273-2504 - Attn: Patient Financial Counselor\n* By mail to:\n\n        Ferrell Hospital Community Foundation\n       Attn: Financial Counselor\n       1201 Pine Street\n       Eldorado, IL 62930","source_id":"fap-4c775d6a2921e50b","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Ferrell Hospital will accept applications for its Financial Assistance Program for the first 240 days following the first post discharge bill to the patient, including on accounts sent to collections during the application period.","source_id":"fap-411695974a4f3271","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"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-a537af3cabbdac30","kind":"hospital_web","url":"https://www.ferrellhospital.org/getmedia/39eaa446-0dc8-44b1-b645-0a3684a642ac/ferrell-financial-assistance-policy-rev-01012025.pdf","title":"Financial Assistance Policy Number: FH-PFS-017 Applies to","fetched_on":"2026-10-11","sha256":"a537af3cabbdac30bec8de43265e4d4dbb5a0cef8c6650c0f40fa73755e94a40","effective_date":null},{"id":"application-8c69b85371a0d4d4","kind":"hospital_web","url":"https://www.ferrellhospital.org/getmedia/6f5d92a9-cbb3-4a4b-9137-b8aa40937a46/ferrell-hospital-community-foundation-application-12192024-(1).pdf","title":"[PDF] Ferrell Hospital Community Foundation FINANCIAL ASSISTANCE ...","fetched_on":"2026-10-11","sha256":"8c69b85371a0d4d40e4753263b06d336ecbe29366c86926c86c112d1e3ce221d","effective_date":null},{"id":"summary-27a6f79d20cc89ce","kind":"hospital_web","url":"https://www.ferrellhospital.org/getmedia/7a90af87-0793-4ad4-90f4-916dfc04f725/fhch-fap-plain-language-summary-01012025.pdf","title":"Plain Language Summary of Financial Assistance ...","fetched_on":"2026-10-11","sha256":"27a6f79d20cc89cec8430afde809de1f3858c1a13a1502e47333824a74ded2a8","effective_date":null},{"id":"fap-4c775d6a2921e50b","kind":"hospital_web","url":"https://www.ferrellhospital.org/pay-my-bill/financial-assistance","title":"Ferrell Hospital - Pay My Bill - Financial Assistance","fetched_on":"2026-10-11","sha256":"4c775d6a2921e50bb4948e17f38973019992d3da3cc8bd1ee63424cf3612c30d","effective_date":null},{"id":"fap-411695974a4f3271","kind":"hospital_web","url":"https://www.ferrellhospital.org/getmedia/39eaa446-0dc8-44b1-b645-0a3684a642ac/Ferrell-Financial-Assistance-Policy-rev-01012025.pdf","title":"Financial Assistance Policy","fetched_on":"2026-10-11","sha256":"411695974a4f3271f74b251ae7d52b30382986f51ae660a9874e6482adc0bc82","effective_date":null}],"accuracy":null}