{"hospital":{"ccn":"330033","name":"CHENANGO MEMORIAL HOSPITAL","city":"NORWICH","state":"NY","zip":"13815","phone":"607-337-4111","ownership":"Voluntary non-profit - Private","website_domain":"nyuhs.org","system":null},"version":3,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Less than 200% of FPG 100%","source_id":"summary-28d92a73ed5ca79c","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"200","max_fpl_inclusive":"250","discount_percent":83},{"min_fpl_exclusive":"250","max_fpl_inclusive":"300","discount_percent":67}],"layer":"documented","quote":"Annual Family Income Amount of Discount Less than 200% of FPG 100% 201% to 250% of FPG 83.5% 251% to 300% of FPG 67%","source_id":"summary-28d92a73ed5ca79c","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Patients with insurance, whose health insurance carrier has deemed a service noncovered or has exhausted a benefit level (i.e., Physical Therapy), will be eligible for the Financial Assistance Program.","source_id":"fap-23e35a5d258a554e","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Medicaid"],"layer":"documented","quote":"Any patient that qualifies for Medicaid will automatically have any unpaid financial responsibility for medically necessary services received for the 12 month period prior to the Medicaid qualification date adjusted as Financial Assistance.","source_id":"fap-23e35a5d258a554e","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["pay_stubs","tax_return","proof_of_income","other"],"layer":"documented","quote":"Documents required along with completed application are: 1. Pay Stubs: last 30 days 2. Other Income such as Investments, Child Support, Unemployment, Social Security, Workers’ Compensation 3. Most Recent Tax Return: if self-employed 4. Self-Attestation: if no income is reported 5. 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