{"hospital":{"ccn":"361334","name":"ADENA PIKE MEDICAL CENTER","city":"WAVERLY","state":"OH","zip":"45690","phone":"740-947-2186","ownership":"Voluntary non-profit - Private","website_domain":"adena.org","system":null},"version":3,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"ii. The patient’s individual or family, if applicable, income is at or below 200% of the current Federal Poverty Income Guidelines for a 100% CCP discount.","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":{"value":false,"layer":"documented","quote":"Asset testing is not required for financial assistance for NHSC facilities. Patients will not be denied based on ability to qualify for or participation in government programs such as Medicaid","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"residency":null,"insured_patients_covered":null,"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["photo_id","proof_of_income","pay_stubs"],"layer":"documented","quote":"Required patient documentation to demonstrate eligibility for Charity Care Form of financial assistance may include IRS W-2 forms and/or 1099 forms, paycheck stubs, a valid government issued identification, and/or documentation of sources of other income, including disability payments.","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"phone","detail":"call Adena's customer service line at (740) 779-8786"},{"kind":"email","detail":"email the Financial Aid Department at FinancialCounselingTeam@adena.org"},{"kind":"mail","detail":"request a Financial Aid Policy (FAP), a plain language summary, or financial aid application via mail from Patient Business Services, by calling (740) 779-8786"},{"kind":"in_person","detail":"Applicants may also visit Adena's website at www.adena.org or go to Adena Regional Medical Center, 272 Hospital Rd., Suite 240."}],"layer":"documented","quote":"Application Process for Financial Assistance: Patients with a financial need are encouraged to call Adena's customer service line at (740) 779-8786 , or email the Financial Aid Department at FinancialCounselingTeam@adena.org. An Adena representative will guide you through the financial assistance application process, and all inquiries are confidential. Individuals may request a Financial Aid Policy (FAP), a plain language summary, or financial aid application via mail from Patient Business Services, by calling (740) 779-8786. Hours of operation are 8am-4:30pm M-F; location is 110 Vaughn Lane, Chillicothe, Ohio 45601. Patients can also go to Adena Regional Medical Center, 272 Hospital Rd., Suite 240. Applicants may also visit Adena's website at www.adena.org.","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"window_days_from_first_bill":null,"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"(740) 779-8786","layer":"documented","quote":"Patients with a financial need are encouraged to call Adena's customer service line at (740) 779-8786","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"hours":{"value":"8am-4:30pm M-F","layer":"documented","quote":"Hours of operation are 8am-4:30pm M-F; location is 110 Vaughn Lane, Chillicothe, Ohio 45601.","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"languages":{"value":["Español (Spanish)","नेपाली (Nepali)","العربي (Arabic)","Soomaali (Somali)","中文 (Chinese)","廣東話 (Cantonese)","Русский (Rusian)","Français (French)","Tiếng Việt (Vietnamese)","አማርኛ (Amharic)","한국어 (Korean)","မြန်မာ (Burmese)","ትግሪኛ (Tigrinya)","हिन्दी (Hindi)","Kiswahili (Swahili)"],"layer":"documented","quote":"Language assistance available: [Español (Spanish)](/language-assistance-services) | [नेपाली (Nepali)](/language-assistance-services) | [العربي (Arabic)](/language-assistance-services) | [Soomaali (Somali)](/language-assistance-services) | [中文 (Chinese)](/language-assistance-services) | [廣東話 (Cantonese)](/language-assistance-services) | [Русский (Rusian)](/language-assistance-services) | [Français (French)](/language-assistance-services) | [Tiếng Việt (Vietnamese)](/language-assistance-services) | [አማርኛ (Amharic)](/language-assistance-services) | [한국어 (Korean)](/language-assistance-services) | [မြန်မာ (Burmese)](/language-assistance-services) | [ትግሪኛ (Tigrinya)](/language-assistance-services) | [हिन्दी (Hindi)](/language-assistance-services) | [Kiswahili (Swahili)](/language-assistance-services)","source_id":"billing-5a7d657429f17e80","checked_on":"2026-10-09","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Adena Regional Medical Center (ARMC)","Adena Greenfield Medical Center (AGMC)","Adena Pike Medical Center (APMC)","Adena Medical Group (AMG)","Adena Fayette Medical Center (AFMC)"],"layer":"documented","quote":"SCOPE This policy applies uniformly to both inpatient and outpatient services provided by the following AHS entities: • Adena Regional Medical Center (ARMC) • Adena Greenfield Medical Center (AGMC) • Adena Pike Medical Center (APMC) • Adena Medical Group (AMG) • Adena Fayette Medical Center (AFMC)","source_id":"billing-d9d2531eac55d004","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"billing-5a7d657429f17e80","kind":"hospital_web","url":"https://www.adena.org/patients-and-visitors/billing-and-financial-services/financial-assistance","title":"Financial Assistance | Adena Health","fetched_on":"2026-10-09","sha256":"5a7d657429f17e80faa7c54420e4d76a674f524e99d4f5a037709a13bfda9e14","effective_date":null},{"id":"billing-d9d2531eac55d004","kind":"hospital_web","url":"https://www.adena.org/docs/default-source/billing-and-financial/financial-assistance-policy.pdf?sfvrsn=e9c51c2b_1","title":"Financial Assistance Policy OWNER: Megan Krause AREA","fetched_on":"2026-10-09","sha256":"d9d2531eac55d0040f7da6c5c7473e6774d7d1cfaa8c84f441a38a5e99aeea5c","effective_date":null}],"accuracy":null}