{"hospital":{"ccn":"390093","name":"INDEPENDENCE HEALTH SYSTEM CLARION HOSPITAL","city":"CLARION","state":"PA","zip":"16214","phone":"814-226-9500","ownership":"Voluntary non-profit - Private","website_domain":"independence.health","system":null},"version":3,"status":"published","eligibility":{"free_care_max_fpl":{"value":"250","layer":"documented","quote":"Patients will receive charity care in a range of 100% with income less than 250% of the Federal Poverty Guidelines, or 75% with income greater than 250% but less than 350% of the Federal Poverty Guidelines (see Appendix A for grid).","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"250","max_fpl_inclusive":"350","discount_percent":75}],"layer":"documented","quote":"Patients will receive charity care in a range of 100% with income less than 250% of the Federal Poverty Guidelines, or 75% with income greater than 250% but less than 350% of the Federal Poverty Guidelines (see Appendix A for grid).","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"asset_test":{"value":true,"layer":"documented","quote":"Assets – includes any checking and savings accounts, certificates of deposit, and any other non-retirement liquid assets","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"residency":null,"insured_patients_covered":null,"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Section 8 housing","Food Stamp eligibility","homeless or received care from a homeless clinic"],"layer":"documented","quote":"Presumptive Eligibility for Charity Care will be considered at 100% in instances when a patient may appear eligible for charity care discounts, but there is no financial assistance form on file due to lack of supporting documentation. In the event there is no evidence to support a patient’s eligibility for charity care, Independence Health System will use one or more of the following criteria to make a determination: patients who qualify for section 8 housing, patient is deceased and no estate, Food Stamp eligibility, patient is homeless or received care from a homeless clinic, and family or friends of a patient that provide information establishing the patient’s inability to pay.","source_id":"fap-de6eb434975d5f2c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","social_security_letter","tax_return","pay_stubs","bank_statements"],"layer":"documented","quote":"The following documents are required to verify income and assets: a. Most recently filed 1040 Tax return b. Social Security Benefits for the current year c. Unemployment Benefits d. Child Support Payments e. Paystub(s) last 30 days f. Pension (copy of bank statement if directly deposited)","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"email","detail":"For Butler Memorial Hospital, Clarion Hospital, or Butler Medical Providers, email BHSFinancialClearance@independence.health"},{"kind":"portal","detail":"Visit our website at www.independence.health where the application is listed under \"Patients & Visitors” – “Charity Care/Financial Assistance\""},{"kind":"in_person","detail":"The application is listed on the reverse side of your patient statement"},{"kind":"phone","detail":"For Butler Memorial Hospital, Clarion Hospital, or Butler Medical Providers, call 724-431-2947 Monday through Friday 8:00am to 4:00pm"}],"layer":"documented","quote":"The method(s) for applying or inquiring about our Financial Assistance Policy for Independence Health System: a. To request an application: i. For Butler Memorial Hospital, Clarion Hospital, or Butler Medical Providers, email BHSFinancialClearance@independence.health ii. For Excela facilities, email excelahealth@optum360.com b. Visit our website at www.independence.health where the application is listed under \"Patients & Visitors” – “Charity Care/Financial Assistance” or c. The application is listed on the reverse side of your patient statement or d. Contact our office: i. For Butler Memorial Hospital, Clarion Hospital, or Butler Medical Providers, call 724-431-2947 Monday through Friday 8:00am to 4:00pm ii. For Excela facilities, call 866-322-0961, option 4 to speak with a Financial Assistance specialist","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"window_days_from_first_bill":null,"decision_days":{"value":30,"layer":"documented","quote":"Patients who have applied for Financial Assistance will be notified by telephone or in writing within (30) days of their application as to whether they have been approved or denied.","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"Collection Agency Referral - IHS may use the services of an external collection agency for the collection of patient debt for nonpayment. This will typically occur 120 days after the initial billing.","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"724-431-2947","layer":"documented","quote":"For Butler Memorial Hospital, Clarion Hospital, or Butler Medical Providers, call 724-431-2947 Monday through Friday 8:00am to 4:00pm","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":{"value":"Monday through Friday 8:00am to 4:00pm","layer":"documented","quote":"For Butler Memorial Hospital, Clarion Hospital, or Butler Medical Providers, call 724-431-2947 Monday through Friday 8:00am to 4:00pm","source_id":"fap-40a3b3d855c77dc7","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-40a3b3d855c77dc7","kind":"hospital_web","url":"https://www.independence.health/documents/financial%20assistance/IHS-Financial-Assistance-Policy.pdf","title":"[PDF] Independence Health System (IHS) Financial Assistance Policy","fetched_on":"2026-10-13","sha256":"40a3b3d855c77dc7d5d8324a03c6a1c578107ca147b88c90a47183efbae4ff83","effective_date":null},{"id":"fap-de6eb434975d5f2c","kind":"hospital_web","url":"https://www.independence.health/patients-visitors/financial-services/charity-care-financial-assistance","title":"Charity Care / Financial Assistance","fetched_on":"2026-10-13","sha256":"de6eb434975d5f2ca36acb14da591f375b87a774c5b6c4348d72e4612e0311a9","effective_date":null},{"id":"fap-5a68e327dc3ce7ac","kind":"hospital_web","url":"https://independence.health/patients-visitors/financial-services/charity-care-financial-assistance","title":"Charity Care / Financial Assistance","fetched_on":"2026-10-13","sha256":"5a68e327dc3ce7acba11a1707b56749544224060e3787e8498e9289aa973d2bc","effective_date":null},{"id":"fap-522b6ade4c1b70aa","kind":"hospital_web","url":"http://www.independence.health/patients-visitors/financial-services/charity-care-financial-assistance","title":"Charity Care / Financial Assistance","fetched_on":"2026-10-13","sha256":"522b6ade4c1b70aae5312476c2b603fc938b13230a5d0c91e806abc1f1ff51ca","effective_date":null},{"id":"fap-7bf275984508244f","kind":"hospital_web","url":"https://www.independence.health/documents/financial%20assistance/Financial-Assistance-Policy.09-2026","title":"click here.","fetched_on":"2026-10-13","sha256":"7bf275984508244f67e01770f2eb41a7bc71c17d87d68ecb374998f4d6bd69c1","effective_date":null},{"id":"fap-ebce014e4544765a","kind":"hospital_web","url":"https://independence.health/documents/financial%20assistance/Financial-Assistance-Policy.09-2026","title":"click here.","fetched_on":"2026-10-13","sha256":"ebce014e4544765af9e4c1b311d2538d10d88a965cca9f4c50ecef889ba099cb","effective_date":null}],"accuracy":null}