{"hospital":{"ccn":"390168","name":"INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA","city":"BUTLER","state":"PA","zip":"16001","phone":"724-284-4403","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":"If your annual family income is 250% or less of the FPIG, you will be eligible for free care.","source_id":"fap-a97e53ad812b66e5","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":null,"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Lack of family support for incapacitated patients","Homeless","Mental incompetence as declared by a licensed professional"],"layer":"documented","quote":"Authorized staff within the Business Office will complete the form on the patient’s behalf and research evidence of indigence. If any of the criteria listed below are met, the patient may qualify for Presumptive Charity: 1. State or Federal assistance program enrollment (food stamps, family planning, etc.) 2. Low income housing resident, supported by a county appraisal district record 3. Lack of family support for incapacitated patients 4. Homeless 5. Mental incompetence as declared by a licensed professional 6. Low income as documented by third-party income verification services.","source_id":"fap-a97e53ad812b66e5","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","tax_return","bank_statements"],"layer":"documented","quote":"Federal Tax return, applicant and spouse income for the last thirty days, number of dependents, and bank statements relevant to making a determination of financial need.","source_id":"fap-de6eb434975d5f2c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Mail application to Butler Health System, PO Box 447, East Butler, PA 16029, ATTN: Financial Clearance"},{"kind":"email","detail":"email to BHSFinancialClearance@butlerhealthsystem.org"}],"layer":"documented","quote":"Please sign and return the form and documents as soon as possible to the address/email address below: Butler Health System 724-431-2947: Mail application to Butler Health System, PO Box 447, East Butler, PA 16029, ATTN: Financial Clearance or email to BHSFinancialClearance@butlerhealthsystem.org","source_id":"application-e673c12f4f33e8e6","checked_on":"2026-10-13","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":"877-247-9925","layer":"documented","quote":"Call [877-247-9925](tel:877-247-9925) (8am-4pm, Monday through Friday) or email [pbdindependence@ensemblehp.com](mailto:pbdindependence@ensemblehp.com).","source_id":"fap-de6eb434975d5f2c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":{"value":"8am-4pm, Monday through Friday","layer":"documented","quote":"Call [877-247-9925](tel:877-247-9925) (8am-4pm, Monday through Friday) or email [pbdindependence@ensemblehp.com](mailto:pbdindependence@ensemblehp.com).","source_id":"fap-de6eb434975d5f2c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"languages":null},"coverage":{"facilities":{"value":["Butler Memorial Hospital","Clarion Hospital","Butler Medical Providers"],"layer":"documented","quote":"### Butler Memorial Hospital, Clarion Hospital, and Butler Medical Providers:","source_id":"fap-de6eb434975d5f2c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-de6eb434975d5f2c","kind":"hospital_web","url":"https://www.independence.health/patients-visitors/financial-services/charity-care-financial-assistance","title":"Charity Care / Financial Assistance | Independence Health 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