{"hospital":{"ccn":"360026","name":"KETTERING HEALTH GREENE MEMORIAL","city":"XENIA","state":"OH","zip":"45385","phone":"937-352-2000","ownership":"Voluntary non-profit - Private","website_domain":"ketteringhealth.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"250","layer":"documented","quote":"PROGRAM % FPL DISCOUNT HCAP 0% - 100% 100% Financial Assistance – Extended 0% - 250% 100%","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"250","max_fpl_inclusive":"400","discount_percent":80}],"layer":"documented","quote":"PROGRAM % FPL DISCOUNT HCAP 0% - 100% 100% Financial Assistance – Extended 0% - 250% 100% Financial Assistance – Basic 251% - 400% 80%","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Individual is insured but qualifies for assistance based on financial need to pay for the individual’s balance after insurance","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":{"value":"www.ketteringhealth.org/financial","layer":"documented","quote":"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.","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["proof_of_income","bank_statements","tax_return"],"layer":"documented","quote":"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","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"in_person","detail":""},{"kind":"mail","detail":""}],"layer":"documented","quote":"either in person, by mail, or electronically.","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Financial assistance application will be considered up to 240 days after the first post discharge billing statement.","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"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.","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"(937)-352-2201","layer":"documented","quote":"Kettering Health Greene Memorial 1161 North Monroe Dr Xenia, OH 45385 937-352-2201","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["Spanish"],"layer":"documented","quote":"Copies of our Financial Assistance Policy, Financial Assistance Application Form, and this summary are available in English and Spanish.","source_id":"summary-5e78b111c8aa8f47","checked_on":"2026-10-13","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Kettering Health Greene Memorial"],"layer":"documented","quote":"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.","source_id":"fap-9c48a3bea9e90f20","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-9c48a3bea9e90f20","kind":"hospital_web","url":"https://cdn.ketteringhealth.org/wp-content/uploads/2023/11/NEW-PF-KH-Financial-Assistance-Policy-003.pdf","title":"[PDF] EFFECTIVE DATE 09/28/2023 - Kettering Health","fetched_on":"2026-10-13","sha256":"9c48a3bea9e90f2024fb366486ee9561226cfe1ef33bee3febc54fcb94911397","effective_date":null},{"id":"summary-5e78b111c8aa8f47","kind":"hospital_web","url":"https://ketteringhealth.org/wp-content/uploads/2022/03/PLS-2022.pdf","title":"[PDF] PLAIN LANGUAGE SUMMARY of Financial Assistance Policy","fetched_on":"2026-10-13","sha256":"5e78b111c8aa8f47c8c65d399984d619bb050fe7bb40b43bd83a7a8708343014","effective_date":null},{"id":"billing-91be5a3de2f34c92","kind":"hospital_web","url":"https://ketteringhealth.org/billing-insurance/financial-assistance","title":"Financial Assistance | Kettering Health","fetched_on":"2026-10-13","sha256":"91be5a3de2f34c9251c3012d5eed1d27bd147e77520add4fcf0534584244dbe8","effective_date":null},{"id":"summary-c6b42a3a1c310869","kind":"hospital_web","url":"https://cdn.ketteringhealth.org/wp-content/uploads/2023/12/English-23KH0161-1543-Financial-Assistance-Policy-flyer.pdf","title":"Plain Language Summary of Financial Assistance Policy","fetched_on":"2026-10-13","sha256":"c6b42a3a1c310869dacdce3d0e068c02e3e7363d0296465b5e72e5cfba617d60","effective_date":null},{"id":"fap-a1d9262e99b6db62","kind":"hospital_web","url":"https://cdn.ketteringhealth.org/wp-content/uploads/2026/01/New-Updated-F-KH-Financial-Assistance-Policy-6-25-2025.pdf","title":"Financial Assistance Policy","fetched_on":"2026-10-13","sha256":"a1d9262e99b6db6231fa3da56f2f7dd033617e65a90515bba4a88a18d4c10dbe","effective_date":null},{"id":"fap-0372400e1c01b988","kind":"hospital_web","url":"https://cdn.ketteringhealth.org/wp-content/uploads/2026/01/2026-Charity-Scale-.pdf","title":"2026 Charity Scale","fetched_on":"2026-10-13","sha256":"0372400e1c01b988c339de37a9ed4fdf19fd959da43128d39185f851460324f2","effective_date":null},{"id":"application-f3a01e1b01d5b7cf","kind":"hospital_web","url":"https://cdn.ketteringhealth.org/wp-content/uploads/2026/08/26KH0009-0861-Patient-Application-for-Financial_Medication-Assistance-FNL-FNL.pdf","title":"Patient Application for Financial/Medication Assistance","fetched_on":"2026-10-13","sha256":"f3a01e1b01d5b7cf90353357b00e77e3c86e3b3cd5be5696fbdbc468c537db24","effective_date":null}],"accuracy":null}