{"hospital":{"ccn":"360025","name":"FIRELANDS REGIONAL MEDICAL CENTER","city":"SANDUSKY","state":"OH","zip":"44870","phone":"419-557-7400","ownership":"Voluntary non-profit - Private","website_domain":"firelands.com","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Charity Care –The ability to receive free care for those patients whose gross income is not in excess of 200% of the Federal Poverty Guidelines (See attached Schedule A).","source_id":"fap-431b72091995189c","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"discount_tiers":null,"assistance_ceiling_fpl":null,"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Patients whose income is at or below 302% of the current FPG can be a recipient of Medicare or other third party insurance. (*Subject to contract terms and Federal and State Laws)","source_id":"fap-431b72091995189c","checked_on":"2026-10-11","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":["proof_of_income","social_security_letter","pay_stubs"],"layer":"documented","quote":"You must provide proof of income such as: a copy of your W2, payroll stubs from 3 months prior to the date of service with year to date gross income, Social Security/Disability income, pension income, unemployment, VA benefits, and worker compensation.","source_id":"application-b9d4cdc8f6bd0bc4","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"RETURN TO: Firelands Regional Medical Center, 1111 Hayes Ave., Sandusky, OH 44870 Attn: Financial Counseling"},{"kind":"in_person","detail":"Please ensure that you have all documentation needed to avoid rescheduling. We will evaluate your information and you will receive a letter indicating the status of your application."}],"layer":"documented","quote":"RETURN TO: Firelands Regional Medical Center, 1111 Hayes Ave., Sandusky, OH 44870 Attn: Financial Counseling","source_id":"application-b9d4cdc8f6bd0bc4","checked_on":"2026-10-11","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":"419-557-7879","layer":"documented","quote":"Inquiries can be made directly to any of the staff members involved in the above processes, by contacting the financial assistance staff at 419-557-7879, or by completing an application for financial assistance.","source_id":"fap-431b72091995189c","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":{"value":["Outpatient registration","Pre-registration","Inpatient registration","Patient rooms","Emergency room","Cashier's office","Patient financial services, Financial Counseling"],"layer":"documented","quote":"Financial assistance screening and services are provided in the following areas of Firelands Regional Medical Center: 1. Outpatient registration 2. Pre-registration 3. Inpatient registration 4. Patient rooms 5. Emergency room 6. Cashier 's office 7. Patient financial services, Financial Counseling","source_id":"fap-431b72091995189c","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-431b72091995189c","kind":"hospital_web","url":"https://www.firelands.com/app/files/public/2062/Financial-Assistance-Policy-Feb-2021.pdf","title":"FINANCIAL ASSISTANCE POLICY","fetched_on":"2026-10-11","sha256":"431b72091995189c310112097709a759c0b2ea95ccce07562cfabb2c2ea388c2","effective_date":null},{"id":"application-b9d4cdc8f6bd0bc4","kind":"hospital_web","url":"https://www.firelands.com/app/files/public/1358/Financial-Assistance-Application-2019.pdf","title":"Financial Assistance Application","fetched_on":"2026-10-11","sha256":"b9d4cdc8f6bd0bc4b51ed44abd878be3f46893594b4b0bae72390b2b7dc6fc27","effective_date":null},{"id":"billing-7be3492728329d22","kind":"hospital_web","url":"https://www.firelands.com/patients-guests/billing-insurance","title":"Billing & Insurance Services | Firelands Regional Medical Center","fetched_on":"2026-10-11","sha256":"7be3492728329d220cd4a3938df9a8456ee03f561bef8453283d0e4cad3ecc51","effective_date":null},{"id":"billing-99a55ddbd081d14a","kind":"hospital_web","url":"https://www.firelands.com/patients-guests/billing-insurance/price-transparency","title":"Price Transparency | Firelands Health","fetched_on":"2026-10-11","sha256":"99a55ddbd081d14afedbd6b42e368609c22ff472084a2bf1bdf6ebca33175df4","effective_date":null},{"id":"billing-d729a8c203bd559f","kind":"hospital_web","url":"https://www.firelands.com/patients-guests/billing-insurance/financial-assistance/","title":"Financial Assistance","fetched_on":"2026-10-11","sha256":"d729a8c203bd559f1b6461c8cced821137463a7b5b2555c5d022bb3bce38f4a1","effective_date":null},{"id":"billing-869bfb6d78c4783d","kind":"hospital_web","url":"https://www.firelands.com/app/files/public/0fe1bc43-0577-48d7-b503-fdd22661f7b4/PS-674%20Surprise%20Billing%20Protection_ES.pdf","title":"Haga clic aquí para obtener más información sobre sus derechos y protecciones contra facturas médicas sorpresa.","fetched_on":"2026-10-11","sha256":"869bfb6d78c4783de4b4927075f7a0fb997c8efb1a9e77ada605decf48133341","effective_date":null},{"id":"billing-c907845a166a93fe","kind":"hospital_web","url":"https://www.firelands.com/patients-guests/billing-insurance/financial-assistance/?https://www.firelands.com/patients-guests/billing-insurance/financial-assistance/","title":"financial assistance","fetched_on":"2026-10-11","sha256":"c907845a166a93feeef0b072aeda3eb1f7a13c54d8270c5bb8c0bdfeada2e282","effective_date":null}],"accuracy":null}