{"hospital":{"ccn":"390139","name":"BRYN MAWR HOSPITAL","city":"BRYN MAWR","state":"PA","zip":"19010","phone":"610-526-3000","ownership":"Voluntary non-profit - Private","website_domain":"mainlinehealth.org","system":null},"version":3,"status":"published","eligibility":{"free_care_max_fpl":{"value":"300","layer":"documented","quote":"Full Financial Assistance: Full Financial Assistance means the ability to receive “free care”. Patients who are uninsured for the relevant, medically necessary service, who are ineligible for governmental or other insurance coverage, and who have family incomes not in excess of 300% of the Federal Poverty Level will be eligible to receive “free care”.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"300","max_fpl_inclusive":"500","discount_percent":86}],"layer":"documented","quote":"Partial Financial Assistance: Partial Financial Assistance is provided to patients who have family incomes in excess of 300%, but not exceeding 500%, of the Federal Poverty Level. These patients will be eligible to receive Financial Assistance in the form of an 86% discount off gross charges for an uninsured patient, or an 86% discount off of the remaining balance after insurance for an insured patient.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"These patients will be eligible to receive Financial Assistance in the form of an 86% discount off gross charges for an uninsured patient, or an 86% discount off of the remaining balance after insurance for an insured patient.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Enrolled in a state-funded prescription programs","Being homeless or receiving care from a homeless clinic","Being eligible for food stamps","Receiving subsidized school lunches"],"layer":"documented","quote":"Presumptive eligibility may be determined on the basis of individual life circumstances that may include: 1. Enrolled in a state-funded prescription programs; 2. Being homeless or receiving care from a homeless clinic; 3. Participating in the Pennsylvania Department of Welfare’s Women, Infants and Children programs (WIC); 4. Being eligible for food stamps; 5. Receiving subsidized school lunches; 6. Being eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down); 7. Residing in low income/subsidized housing, providing the address supplied by the patient is a valid address; and 8. Patient is deceased with no known estate or no funds remaining in estate.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","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","medicaid_denial"],"layer":"documented","quote":"Documentation that may be requested:  Medical Assistance eligibility/denial notice from the State of Pennsylvania and/or County Services (Form PA 162);  Current year IRS Form 1040 Tax Return and appropriate schedules, if applicable;  Proof of income and Adjusted Gross Income such as: • Pay stubs from the past six (6) pay periods • W-2 withholding statement • Current year Social Security Benefit Verification letter • Social Security checks, receipts or deposits • Bank statements from the last twelve (12) months - checking and savings • Any other documentation or notarized letters that may serve as proof of eligibility","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Main Line Health - 3803 West Chester Pike, Suite 160, Newtown Square, PA 19073"},{"kind":"fax","detail":"484-227-9005"},{"kind":"in_person","detail":"dropped off directly to one of our Financial Counseling or Cashiers Offices located at any one of our hospitals"}],"layer":"documented","quote":"Applications may also be Faxed to 484-227-9005 OR dropped off directly to one of our Financial Counseling or Cashiers Offices located at any one of our hospitals. If you have questions, please contact the MLH Customer Service Team at: 484-337-1970. If directed to a Financial Assistance representative, please allow up to three (3) Business Days for a return call.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Approvals are valid for one (1) year and may only cover services within the previous two hundred forty (240) days from first statement date.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"decision_days":{"value":30,"layer":"documented","quote":"Individuals will be notified of the determination within thirty (30) days.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"484-337-1970","layer":"documented","quote":"Questions regarding this Policy: Individuals may contact the MLH Customer Service Team at 484-337-1970 or request to speak to a representative in the MLH Financial Counseling office at each respective MLH Hospital.","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":{"value":["Lankenau Medical Center","Bryn Mawr Hospital","Paoli Hospital","Riddle Hospital","Bryn Mawr Rehabilitation Hospital","Mirmont Treatment Center","Paoli Surgery Center"],"layer":"documented","quote":"Participating Hospitals: Lankenau Medical Center Bryn Mawr Hospital Paoli Hospital Riddle Hospital Bryn Mawr Rehabilitation Hospital Mirmont Treatment Center Paoli Surgery Center","source_id":"fap-cdf0afdb1a1ff900","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-cdf0afdb1a1ff900","kind":"hospital_web","url":"https://www.mainlinehealth.org/-/media/files/pdf/basic-content/about/policies/financial-assistance/mlh-financial-assistance-policy-english.pdf","title":"Patient Financial Assistance Policy","fetched_on":"2026-10-11","sha256":"cdf0afdb1a1ff90069b6addf2ebc20a2e8be8e516601cccb8a5e1f5cc48f93b3","effective_date":null},{"id":"summary-12ea49a919325f6d","kind":"hospital_web","url":"https://www.mainlinehealth.org/patient-services/patient-billing/financial-assistance/program-summary","title":"Summary of Financial Assistance Policy | Patient Billing | Patient Services | Main Line Health","fetched_on":"2026-10-11","sha256":"12ea49a919325f6d69e80da543ef948105101e3ca05394e2f7621f54943003f1","effective_date":null},{"id":"billing-6abcccf595109076","kind":"hospital_web","url":"https://www.mainlinehealth.org/patient-services/patient-billing/financial-assistance","title":"Financial Assistance | Patient Billing | Patient Services | Main Line Health","fetched_on":"2026-10-11","sha256":"6abcccf5951090763538be20127be5a380ca256db34431467a9be07660b546ac","effective_date":null},{"id":"billing-c2f452ee60b92ccf","kind":"hospital_web","url":"https://www.mainlinehealth.org/-/media/files/pdf/basic-content/about/policies/billing-and-collection-policy.pdf","title":"Billing and Collections Policy (PDF)","fetched_on":"2026-10-11","sha256":"c2f452ee60b92ccf2eae3610fa764e53e885d1a6d1094d7fb02c7e6fc6ee7502","effective_date":null},{"id":"fap-c48a59ff3d1077ee","kind":"hospital_web","url":"https://my.mainlinehealth.org/MyChart/Authentication/Login?postloginurl=FinancialAssistance","title":"Sign in to MyChart","fetched_on":"2026-10-11","sha256":"c48a59ff3d1077eeccce284c6d06cec8381846bcad41680fd9ab3a3299b3ae0f","effective_date":null},{"id":"fap-fcb4b1c73f5850b1","kind":"hospital_web","url":"https://www.mainlinehealth.org/-/media/files/pdf/basic-content/about/policies/financial-assistance/mlh-financial-assistance-policy-spanish.pdf","title":"Política de Asistencia Financiera — Español (PDF)","fetched_on":"2026-10-11","sha256":"fcb4b1c73f5850b1f42e18ce4f23730091a2d9cdfb5138aeeeb2191d7a1a4e05","effective_date":null}],"accuracy":null}