NICHOLAS H NOYES MEMORIAL HOSPITAL

DANSVILLE, NY · version 3 · published · JSON

eligibility.free_care_max_fpl200% of the federal poverty level

"A 100% discount is available to individuals and families with annual incomes at or below 200% of the FPG."

documented · checked 2026-10-14 · Noyes Health Financial Assistance Policy - UR Medicine

eligibility.discount_tiersAbove 200% up to 300% of FPL: 90% discount
Above 300% up to 400% of FPL: 80% discount

"Discount Gross Income as % of Federal Poverty Level 100% UP TO 200% 90% BETWEEN 201 – 300% 80% BETWEEN 301 - 400% 0% OVER 401%"

documented · checked 2026-10-14 · Noyes Health Financial Assistance Policy - UR Medicine

eligibility.insured_patients_coveredYes

"This Financial Assistance Policy has been developed to help patients who are either uninsured or underinsured, after exhausting all efforts to apply for and/or obtain insurance coverage."

documented · checked 2026-10-14 · Noyes Health Financial Assistance Policy - UR Medicine

programs.presumptiveMedicaid

"Note: Patients are also considered presumptively eligible for 100% financial assistance if they are eligible for Medicaid and have outstanding balances prior to being covered by Medicaid."

documented · checked 2026-10-14 · Noyes Health Financial Assistance Policy - UR Medicine

apply.documents_requiredSocial Security letter

"Copy of award letter/certificate, or monthly benefit statement from NYS Department of Labor, or Copy of Direct Payment Card with printout, or Correspondence from the NYS Department of Labor, or Printout of recipient’s account information from the NYS Department of Labor’s website (www.labor.state.ny.us)."

documented · checked 2026-10-14 · [PDF] NYS Uniform Hospital Financial Assistance Application | UR Medicine

apply.submit_methodsMail: Please submit your completed application by mail, email or fax; UR Medicine Affiliate Billing Office 73 Buffalo St, suite 100 Canandaigua, NY 14424 Attn: Financial Assistance
Email: Email: URMCAffiliateFinancialAssistance@URMC.Rochester.edu
Fax: Fax: 585/340-4018

"Please submit your completed application by mail, email or fax; UR Medicine Affiliate Billing Office 73 Buffalo St, suite 100 Canandaigua, NY 14424 Attn: Financial Assistance Email: URMCAffiliateFinancialAssistance@URMC.Rochester.edu Fax: 585/340-4018"

documented · checked 2026-10-14 · [PDF] NYS Uniform Hospital Financial Assistance Application | UR Medicine

apply.decision_days30 days

"Fully completed Financial Assistance applications are processed timely, and determinations are communicated to the patients within 30 days."

documented · checked 2026-10-14 · Noyes Health Financial Assistance Policy - UR Medicine

collections.eca_wait_days180 days

"• Hospitals cannot send unpaid bills to a collection agency for at least 180 days after your first bill."

documented · checked 2026-10-14 · [PDF] NYS Uniform Hospital Financial Assistance Application | UR Medicine

contacts.phone(585) 396-6515

"until 4:30 p.m."

documented · checked 2026-10-14 · Noyes Health Financial Assistance Policy - UR Medicine

contacts.hoursMonday through Friday from 8:00 a.m. until 4:30 p.m.

"until 4:30 p.m."