ATRIUM MEDICAL CENTER
FRANKLIN, OH · version 3 · published · JSON
eligibility.free_care_max_fpl200% of the federal poverty level"100% – 200% 100% 100%"
documented · checked 2026-10-11 · Ohio Hospital Care Assurance Program (HCAP)
eligibility.discount_tiersAbove 200% up to 300% of FPL: 80% discount"Income (of FPG) % of Poverty Level Uninsured Charity Discount Insured Charity Discount 0 – 100% 100% 100% 100% – 200% 100% 100% 200% - 300% 80%/AGB 80%/AGB"
documented · checked 2026-10-11 · Ohio Hospital Care Assurance Program (HCAP)
apply.documents_requiredProof of incomeSocial Security letter
Tax return
Pay stubs
Bank statements
"Proof of income for applicant (and spouse if applicable) such as a pay stub, unemployment insurance payment stubs, or sufficient information on how patients are currently financially supporting themselves. b. Bank Statement c. Social Security Statement d. Tax Return – Schedule C for self-employment income e. Documentation of the family’s assets."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
apply.submit_methodsMail: PO Box 932715, Cleveland, OH 44193Email: via email
Portal: through MyChart
In person: in person
"To apply for financial assistance, patients must submit a complete application including supporting documents upon request, in person, by mail, via email, or through MyChart."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
apply.window_days_from_first_bill240 days"up to 240 days after the first post discharge statement."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
apply.decision_days30 days"Notify the patient in writing regarding the decision within 30 days from the date of the decision."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
collections.eca_wait_days120 days"Premier Health Hospitals will not initiate any ECAs for at least one hundred and twenty (120) days from the date the hospital facility provides the first post-discharge billing statement for the care."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
contacts.phone937-499-7364"Financial counseling office hours are generally 8 am to 7 pm weekdays and can be reached by calling 937-499-7364."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
contacts.hours8 am to 7 pm weekdays"Financial counseling office hours are generally 8 am to 7 pm weekdays and can be reached by calling 937-499-7364."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
contacts.languagesEnglishSpanish
"Applications are available in English and in Spanish."
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
coverage.facilitiesAtrium Medical Center"All hospitals are referred to collectively in this policy as “Premier Health Hospitals.” All Premier Physician Network providers are referred to collectively in this policy as “PPN.”"
documented · checked 2026-10-11 · Tier 2 Financial Assistance Policy Template
Sources
Tier 2 Financial Assistance Policy Template — fetched 2026-10-11
Financial Assistance| Billing | Premier Health — fetched 2026-10-11
Ohio Hospital Care Assurance Program (HCAP) — fetched 2026-10-11
financial-assistance-english-version.pdf — fetched 2026-10-11