{"hospital":{"ccn":"360065","name":"FISHER-TITUS HOSPITAL","city":"NORWALK","state":"OH","zip":"44857","phone":"419-668-8101","ownership":"Voluntary non-profit - Private","website_domain":"ft-data.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"150","layer":"documented","quote":"101%-150% FPL FREE CARE DISCOUNT","source_id":"fap-bf8b1953020fdd83","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Underinsured Insured patients who receive Medically Necessary Care that are determined to be non-covered services or have limited benefit coverage or benefits are exhausted by the insurance provider.","source_id":"fap-bf8b1953020fdd83","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":{"value":"https://www.fishertitus.org/patients-guests/billing-financial-assistance/financial-assistance/","layer":"documented","quote":"Applications may be accessed by visiting the Financial Counseling Department, the Patient Access Department, the Emergency Department, or at the Cashier’s window at the hospital, from the hospital website at https://www.fishertitus.org/patients-guests/billing-financial-assistance/financial-assistance/, via email at financeservices@ftmc.com, or by requesting an application by phone at 419.660.2678 or 419.660.2679.","source_id":"fap-bf8b1953020fdd83","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["proof_of_income","pay_stubs","bank_statements"],"layer":"documented","quote":"*Income verification MUST be attached and should include: Current W2 ’s, 2 Current paystubs, Current S.S. Benefits Letter, Pension/401K, Unemployment Stmt. Etc.\n\nCurrent 1-month Bank Statement is required .","source_id":"fap-3b696889a05678fb","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"It is the responsibility of the patient to complete a charity app within 240 days of the date of the first statement if they believe their annual income for their family size may qualify them for possible assistance.","source_id":"fap-bf8b1953020fdd83","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"decision_days":{"value":45,"layer":"documented","quote":"THIS APPLICATION MAY TAKE UP TO 45 DAYS TO PROCESS","source_id":"fap-3b696889a05678fb","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"The hospital will notify the patient about the FAP before initiating any ECAs to obtain payment for care and will refrain from initiating such ECAs for at least 120 days from the date of the first statement.","source_id":"fap-bf8b1953020fdd83","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"419.660.2678 or 419.660.2679","layer":"documented","quote":"or by requesting an application by phone at 419.660.2678 or 419.660.2679.","source_id":"fap-bf8b1953020fdd83","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Español","Deutsch","Français","العربية","Deitsch","Русский","Italiano","Tiếng Việt","Oroomiffa","Soomaali","日本語","Nederlands","Українська","Română","한국어","繁體中文"],"layer":"documented","quote":"Meeshaaleenii fi tajaajiloonni qaama miidhamtootaaf bifa hubachuu danda’aniin odeeffannoo akka argatan gargaaran baasii tokko malee/bilisaan ni kennamu.","source_id":"fap-3b696889a05678fb","checked_on":"2026-10-11","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Fisher-Titus Medical Center"],"layer":"documented","quote":"Fisher-Titus Medical Center 272 Benedict Avenue Norwalk, OH 44857","source_id":"fap-bf8b1953020fdd83","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-bf8b1953020fdd83","kind":"hospital_web","url":"https://ft-data.org/wp-content/uploads/2025/08/Fisher-Titus-Financial-Assistance-Policy-2025-UPDATE.pdf","title":"Fisher Titus Financial Assistance Policy","fetched_on":"2026-10-11","sha256":"bf8b1953020fdd83c354a8d43c6552322ea91032581fb42e2d8f7e24c1578eef","effective_date":null},{"id":"fap-3b696889a05678fb","kind":"hospital_web","url":"https://ft-data.org/wp-content/uploads/2025/08/Service-Documents_FINANCIAL-ASST.-APP-2022-UPDATED-.pdf","title":"Fisher Titus Health Care Assurance and Financial Assistance ...","fetched_on":"2026-10-11","sha256":"3b696889a05678fbf438f79893c159f67930f542d43803f10552a36c98b5533a","effective_date":null}],"accuracy":null}