KETTERING HEALTH GREENE MEMORIAL
XENIA, OH · version 1 · published · JSON
eligibility.free_care_max_fpl250% of the federal poverty level"PROGRAM % FPL DISCOUNT HCAP 0% - 100% 100% Financial Assistance – Extended 0% - 250% 100%"
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
eligibility.discount_tiersAbove 250% up to 400% of FPL: 80% discount"PROGRAM % FPL DISCOUNT HCAP 0% - 100% 100% Financial Assistance – Extended 0% - 250% 100% Financial Assistance – Basic 251% - 400% 80%"
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
eligibility.insured_patients_coveredYes"Individual is insured but qualifies for assistance based on financial need to pay for the individual’s balance after insurance"
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
apply.form_urlwww.ketteringhealth.org/financial"The financial assistance form is available in the emergency departments and registration areas of the hospital and on the KH website at www.ketteringhealth.org/financial."
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
apply.documents_requiredProof of incomeBank statements
Tax return
"In addition to completing the application form, individuals should supply, but not limited to, the following documentation: a. Proof of income for applicant (and spouse, if applicable) such as pay stubs, unemployment payment stubs, or other information on how patients are currently financially supporting themselves b. Bank statements c. Tax return d. Documentation of assets"
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
apply.submit_methodsIn person: Mail:
"either in person, by mail, or electronically."
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
apply.window_days_from_first_bill240 days"Financial assistance application will be considered up to 240 days after the first post discharge billing statement."
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
collections.eca_wait_days120 days"KH or its authorized agents will not initiate any ECAs for at least 120 days from the date KH provides the first post-discharge billing statement."
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
contacts.phone(937)-352-2201"Kettering Health Greene Memorial 1161 North Monroe Dr Xenia, OH 45385 937-352-2201"
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
contacts.languagesSpanish"Copies of our Financial Assistance Policy, Financial Assistance Application Form, and this summary are available in English and Spanish."
documented · checked 2026-10-13 · [PDF] PLAIN LANGUAGE SUMMARY of Financial Assistance Policy
coverage.facilitiesKettering Health Greene Memorial"Kettering Health (KH) Organization-Wide Policy KH adopts this policy for KH Main, KH Miamisburg, KH Behavioral Medical Center, KH Dayton, KH Washington Township, KH Greene Memorial, Soin Medical Center, KH Hamilton, KH Troy, KH Medical Group, KH Transportation Services, all hospital off-sites and KH facilities, KH Senior Living, and Kettering Network Services."
documented · checked 2026-10-13 · [PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health
Sources
[PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health — fetched 2026-10-13
[PDF] PLAIN LANGUAGE SUMMARY of Financial Assistance Policy — fetched 2026-10-13
Financial Assistance | Kettering Health — fetched 2026-10-13
Plain Language Summary of Financial Assistance Policy — fetched 2026-10-13
Financial Assistance Policy — fetched 2026-10-13
2026 Charity Scale — fetched 2026-10-13
Patient Application for Financial/Medication Assistance — fetched 2026-10-13