CHILTON MEDICAL CENTER
POMPTON PLAINS, NJ · version 3 · published · JSON
eligibility.free_care_max_fpl200% of the federal poverty level"Charity Care will cover 100% of hospital charges for patients with family gross income less than or equal to 200% of the federal poverty level"
documented · checked 2026-10-11 · Atlantic Health System (“AHS”), Inc.'s Financial Assistance ...
eligibility.insured_patients_coveredYes"An insured or underinsured patient has up to 365 days from the first post-discharge billing statement reflecting processing by an insurer to submit a completed application for financial assistance."
documented · checked 2026-10-11 · Billing and Collection Policy/Financial Assistance for Low- ...
apply.documents_requiredPhoto IDProof of income
Social Security letter
Tax return
Pay stubs
Bank statements
Proof of residency
"**Proper patient and family identification documents, such as:** * Driver’s license * Social security card * Alien registry card * Birth certificate * Paycheck stub * Passport * Visa **Provide proof of gross income with one of the following:** * Actual gross income for the 12 months immediately preceding services * Actual gross income for the three months immediately preceding services * Actual gross income for the month immediately preceding services **Proof of assets as of the date of service, including items readily convertible into cash, such as:** * Stocks * Bonds * IRAs * CDs * Checking and savings accounts * Equity in a non-primary residence Proof of New Jersey residency as of the date of service (emergency care may be an exception). Acceptable documents include: * Driver’s license * Utility bill * Federal income tax return * State income tax return * Lease"
documented · checked 2026-10-11 · Financial Assistance and Charity Care | Atlantic Health
apply.submit_methodsMail: Send applications to the applicable mailing address below:
Chilton Medical Center 97 West Parkway
Attn: Financial Counseling
Pompton Plains, NJ 07444Fax: You may bring your application to the hospital in person, mail it, fax it, or e-mail it.
Email: You may bring your application to the hospital in person, mail it, fax it, or e-mail it.
In person: You may bring your application to the hospital in person, mail it, fax it, or e-mail it.
"You may bring your application to the hospital in person, mail it, fax it, or e-mail it."
documented · checked 2026-10-11 · Atlantic Health System (“AHS”), Inc.'s Financial Assistance ...
apply.window_days_from_first_bill365 days"An uninsured patient has up to 365 days after the first post-discharge billing statement to submit a completed application for financial assistance."
documented · checked 2026-10-11 · Billing and Collection Policy/Financial Assistance for Low- ...
apply.decision_days10 days"The Financial Counseling Office makes a determination of whether the applicant is eligible no later than ten (10) working days from the day the completed initial application was received."
documented · checked 2026-10-11 · Billing and Collection Policy/Financial Assistance for Low- ...
collections.eca_wait_days120 days"For uninsured patients, the first post-discharge billing statement marks the beginning of the 120-day notification period in which no extraordinary collection actions (“ECA”) (defined below) may be initiated against the patient."
documented · checked 2026-10-11 · Billing and Collection Policy/Financial Assistance for Low- ...
Sources
Financial Assistance and Charity Care | Atlantic Health — fetched 2026-10-11
Atlantic Health System — fetched 2026-10-11
Atlantic Health System (“AHS”), Inc.'s Financial Assistance ... — fetched 2026-10-11
Billing and Collection Policy/Financial Assistance for Low- ... — fetched 2026-10-11
Arabic Language — fetched 2026-10-11
Armenian Language — fetched 2026-10-11
Brazilian Portuguese Language — fetched 2026-10-11
Croatian Language — fetched 2026-10-11