{"hospital":{"ccn":"330307","name":"CAYUGA MEDICAL CENTER AT ITHACA","city":"ITHACA","state":"NY","zip":"14850","phone":"607-274-4401","ownership":"Voluntary non-profit - Private","website_domain":"cayugamed.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"100","layer":"documented","quote":"A patient whose household income, as determined by the application income worksheet, is equal to or less than 100% of the most recent Federal Poverty Guidelines qualifies for a nominal payment limit as designated by major service category, the rest will be written off.","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Per section 2807-k of the NYDOH regulations, patients can qualify for financial assistance under the following conditions: (a) low income patients with no health insurance; or (b) low income patients who have exhausted their insurance benefits; or (c) low income patients who have an inability to pay co-pays and deductible amounts, at the hospital´s discretion.","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["pay_stubs","social_security_letter"],"layer":"documented","quote":"Please attach pay stubs for the most recent 3 month period.\n\nMonthly Interest / Dividends: $ _________ Please provide copies of most recent statements\n\nMonthly Child Support / Alimony: $ _________ Please provide supporting documentation\n\nMonthly Pension / Social Security: $ _________ Please provide copies of most recent statements\n\nMonthly Rental / Other Income: $ _________ Please provide supporting documentation","source_id":"application-4b7c376d030ea80a","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":null,"decision_days":{"value":30,"layer":"documented","quote":"All applications are to be submitted to a CHS Financial Counselor, who will make a decision of eligibility within thirty (30) days of receipt of the completed application.","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":{"value":121,"layer":"documented","quote":"Extraordinary Collections Actions (ECAs) – including, but not limited to, reporting adverse information to credit bureaus or placing liens on property - cannot commence until at least 121 days after the 1st billing statement and requires that the patient be notified 30 days in advance with a pre-collect letter outlining what ECAs will occur and when (See Appendix H)","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"(607) 274-4400","layer":"documented","quote":"Please contact Cayuga Medical Center's Patient Billing Office at (607) 274-4400 with any questions.","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["Chinese"],"layer":"documented","quote":"Cayuga Medical Center and Cayuga Medical Associates currently provide a translated copy of the FAP brochure in Chinese","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Cayuga Medical Center","Cayuga Medical Associates","Schuyler Hospital"],"layer":"documented","quote":"Entities participating in the Cayuga Health System Financial Assistance Program include: Cayuga Medical Center, Cayuga Medical Associates, & Schuyler Hospital","source_id":"fap-e62ac435d0439891","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-e62ac435d0439891","kind":"hospital_web","url":"http://www.cayugamed.org/wp-content/uploads/2022/08/Financial-Assistance-Policy_CMC_Revised-10.1.20204.pdf","title":"[PDF] Financial Assistance and Charity Program - Ithaca - Cayuga Health","fetched_on":"2026-10-10","sha256":"e62ac435d0439891d72e05e056e3f6409e4195e407c44b75eaaf854013a7c492","effective_date":null},{"id":"application-4b7c376d030ea80a","kind":"hospital_web","url":"https://www.cayugamed.org/wp-content/uploads/2017/10/02025-Financial-Assistance-Program-Application-4-20-16.pdf","title":"[PDF] Financial Assistance Program Application - Cayuga Medical Center","fetched_on":"2026-10-10","sha256":"4b7c376d030ea80afc22fa1fc8d74102d854ae23bce1426f4371502ac6fc40c5","effective_date":null}],"accuracy":null}