MADISON HEALTH

"If you and/or the responsible party’s income combined is at or below 200% of the federal poverty guidelines and you are a resident of the State of Ohio, you will have no financial responsibility for the care given by Madison Health."

documented · checked 2026-10-13 · [PDF] 15 Plain Language Summary Financial Assistance Policy Overview

"• The most common documents for establishing income are the patient’s pay stubs. Tax returns and schedules, bank statements, and credit history may also be used. This information will be maintained with the completed assessment. Any of this information may be requested to verify income."

documented · checked 2026-10-13 · [PDF] Madison Health Financial Assistance Program Policy ( MH-FAP ...

"Madison Health must refrain from initiating the ECAs until 120 days after it provides the first post discharge billing."

documented · checked 2026-10-13 · Billing and Collection Policy

"Request the information by calling 740-845-7033 or 740-845-7031."

documented · checked 2026-10-13 · [PDF] 15 Plain Language Summary Financial Assistance Policy Overview

"[Application for Financial Assistance (English)](https://www.madison-health.com/content/uploads/2023/04/Madison-Health-Financial-Assistance-Application-2024.pdf) [Application for Financial Assistance (Spanish)](http://www.madison-health.com/content/uploads/2025/04/Financial-Assistance-Application-Spanish.pdf)"

documented · checked 2026-10-13 · Billing & Insurance | Madison Health

"Financial assistance applications are to be submitted to the following office: Madison Health Patient Financial Counselor 210 North Main Street London, Ohio 43140"

documented · checked 2026-10-13 · [PDF] 15 Plain Language Summary Financial Assistance Policy Overview