{"hospital":{"ccn":"220119","name":"BRIGHAM AND WOMEN FAULKNER HOSPITAL","city":"JAMAICA PLAIN","state":"MA","zip":"02130","phone":"617-983-7000","ownership":"Voluntary non-profit - Private","website_domain":"massgeneralbrigham.org","system":null},"version":7,"status":"published","eligibility":{"free_care_max_fpl":{"value":"150","layer":"documented","quote":"Family Income % FPG Discount 0 to 150% 100%","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"150","max_fpl_inclusive":"250","discount_percent":85},{"min_fpl_exclusive":"250","max_fpl_inclusive":"300","discount_percent":70}],"layer":"documented","quote":"Family Income % FPG Acute Care Hospitals listed in Appendix 1 EXCEPT WDH Wentworth-Douglass Hospital (WDH) 0 to 150% 100%1 100% 150.1 to 250% 85%2 100% 251 to 300% 70%3 0%","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"asset_test":{"value":true,"layer":"documented","quote":"Assets will also be used when: • Patient’s residency is outside the U.S. or Canada.","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"residency":null,"insured_patients_covered":{"value":false,"layer":"documented","quote":"You may qualify if: * You do not qualify for public insurance programs in your home state, and","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":{"value":[{"name":"Health Safety Net (Massachusetts)","how_to_apply":"Apply through the MassHealth application; a hospital financial counselor can file it for you. The hospital's own financial assistance and the Health Safety Net are separate programs."}],"layer":"documented","quote":"Important information you need to know about applying for MassHealth Limited and the Health Safety Net can be found on page 3.","source_id":"state-mass-cafb5ebe5d7f","checked_on":"2026-10-02","confidence":1.0,"support_count":0}},"apply":{"form_url":{"value":"/content/dam/unified-xwalk/documents/en/patients-visitors/financial-assistance-application-english.pdf","layer":"documented","quote":"[Financial Assistance Policy - Full version (PDF)](/content/dam/unified-xwalk/documents/en/patients-visitors/financial-assistance-policy-english.pdf)\n\n[Financial Assistance Policy - Plain language version (PDF)](/content/dam/unified-xwalk/documents/en/patients-visitors/financial-assistance-summary-english.pdf)\n\n[Credit and Collection Policy (PDF)](/content/dam/unified-xwalk/documents/en/patients-visitors/credit-collection-policy-english.pdf)\n\n[Application (PDF)](/content/dam/unified-xwalk/documents/en/patients-visitors/financial-assistance-application-english.pdf)","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["photo_id","proof_of_income","other"],"layer":"documented","quote":"* Complete and submit a paper application (found in the financial application section) along with ID and income verification.","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"email","detail":"patientbilling@partners.org"},{"kind":"portal","detail":""},{"kind":"in_person","detail":"Visit a patient financial counselor at your hospital or health center"}],"layer":"documented","quote":"Please call [617-726-3884](tel:617-726-3884) or e-mail [patientbilling@partners.org](mailto:patientbilling@partners.org) to request information and application forms.\n\n**In person:** Visit a patient financial counselor at your hospital or health center. For a list of patient financial counselors' contact information, please browse to the contact a financial counselor section of this page.","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","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":"617-983-7218","layer":"documented","quote":"**Brigham and Women’s Faulkner Hospital\n\n**Patient Financial Services**\n1153 Centre Street Suite 1106\nBoston, MA 02130\n[617-983-7218](tel:617-983-7218)","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Arabic / عربى","Chinese (Traditional) / 中文","Haitian Creole / Kreyòl Ayisyen","Indonesian / Bahasa Indonesia","Khmer (Cambodian) / ខ្មែរ","Portuguese (Brazilian) / Português","Russian / русский","Spanish / Español","Vietnamese / Tiếng Việt"],"layer":"documented","quote":"[Financial Assistance Policy - Plain language version / Règleman konsènan Èd Finansye - vèsyon langaj òdinè (PDF)](/content/dam/unified-xwalk/documents/ht/patients-visitors/financial-assistance-summary-haitian-creole.pdf)","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Brigham and Women’s Faulkner Hospital"],"layer":"documented","quote":"Brigham and Women’s Faulkner Hospital\n\n**Patient Financial Services**\n1153 Centre Street Suite 1106\nBoston, MA 02130\n[617-983-7218](tel:617-983-7218)","source_id":"application-dc0301e9ce23d133","checked_on":"2026-10-03","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"application-dc0301e9ce23d133","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/patient-information/financial-assistance","title":"Financial Assistance | Mass General Brigham","fetched_on":"2026-10-02","sha256":"dc0301e9ce23d133fc7baeb08ba9d788bae7469a098fc239fbb58c1a7fb6a43e","effective_date":null},{"id":"billing-4de2ce6d32abf574","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/en/patients-visitors/billing-insurance/billing/financial-assistance","title":"Financial Assistance | Mass General Brigham","fetched_on":"2026-10-02","sha256":"4de2ce6d32abf574366e9575dd9a71c190cb8cdbf8cce0dfbd647ecdf3b0902a","effective_date":null},{"id":"fap-111a492d2aab30fc","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/content/dam/unified-xwalk/documents/en/patients-visitors/financial-assistance-policy-english.pdf","title":"Financial Assistance Policy - Full version (PDF)","fetched_on":"2026-10-02","sha256":"111a492d2aab30fc9f28255a487b3253acfd64dd165f262fa8709ee6414dbf56","effective_date":null},{"id":"fap-7196b2d900eb066a","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/content/dam/unified-xwalk/documents/zh/patients-visitors/financial-assistance-policy-chinese.pdf","title":"Financial Assistance Policy - Full version / 財務援助政策 完整版 (PDF)","fetched_on":"2026-10-02","sha256":"7196b2d900eb066a5cd9a7245ce621f300bb088e6ee3198f645d5786e88ec022","effective_date":null},{"id":"fap-a324bdea17060ba8","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/content/dam/unified-xwalk/documents/ht/patients-visitors/financial-assistance-policy-haitian-creole.pdf","title":"Financial Assistance Policy - Full version / Règleman konsènan ed finansye - vèsyon konplè (PDF)","fetched_on":"2026-10-02","sha256":"a324bdea17060ba8eb4acf1efa5f16bf9c3e182b26396ce1efc35f6bc86b6a33","effective_date":null},{"id":"fap-f9ec43a6496017b1","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/content/dam/unified-xwalk/documents/ar/patients-visitors/financial-assistance-policy-arabic.pdf","title":"Financial Assistance Policy - Full version / سياسة المساعدة المالية - النسخة الكاملة (PDF)","fetched_on":"2026-10-02","sha256":"f9ec43a6496017b1cdffb505387e87451083a13ac7fc83f6322e379ad6e0617f","effective_date":null},{"id":"state-mass-cafb5ebe5d7f","kind":"state_repository","url":"https://www.mass.gov/doc/senior-guide-to-health-care-coverage-4/download","title":"download","fetched_on":"2026-10-02","sha256":"cafb5ebe5d7fd181e3c87567b6609c3aa6ee7fff9af006d521a3a53700a99472","effective_date":null}],"accuracy":null}