LOWER BUCKS HOSPITAL

"0% - 350% 100% (Charity Care)"

documented · checked 2026-10-13 · Financial Assistance Policy

"B. Insured Patients A patient who has third party coverage or whose injury is a compensable injury for purposes of workers’ compensation, automobile insurance, or other insurance as determined and documented by the hospital does not qualify for Charity Care but may qualify for the Discount Payment Program based on the conditions discussed in the addendum “Financial Assistance Charity Care & Discount Payment Program”."

documented · checked 2026-10-13 · Financial Assistance Policy

"• Proof of Income from all sources MUST be supplied with this application (e.g., 3 most recent months of pay stubs, most recent tax return (IRS Form 1040), etc.)."

documented · checked 2026-10-13 · Financial Assistance Application Form Instructions

"Mail completed application and supporting documents to: Lower Bucks Hospital, Attention: Business Office 501 Bath Road, Bristol, PA 19007 You may also submit the application and supporting documents in person at the same address."

documented · checked 2026-10-13 · Financial Assistance Application Form Instructions

"A patient is expected to submit the financial assistance application promptly following care, but no later than two hundred forty (240) days following the date of the first post-discharge statement."

documented · checked 2026-10-13 · Financial Assistance Policy

"We will notify you of the final determination of eligibility and appeal rights, if applicable, within 30 days of receiving a complete application and supporting documents."

documented · checked 2026-10-13 · Financial Assistance Application Form Instructions