{"hospital":{"ccn":"390173","name":"INDIANA REGIONAL MEDICAL CENTER","city":"INDIANA","state":"PA","zip":"15701","phone":"724-357-7000","ownership":"Voluntary non-profit - Private","website_domain":"irmc.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Generally, patients with family income of 200% of the Federal Poverty Level or less may be eligible for a discount of 100%.","source_id":"summary-a02b26904000940f","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":{"value":true,"layer":"documented","quote":"**Proof of Assets does not apply to applicants at or below 200% of the current Federal Poverty Level.**","source_id":"fap-3bd68eeaad37e599","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Noncovered: For medically necessary services, Financial Assistance covers patient liability after insurance such as deductible, coinsurance and copays assigned by an insurance plan.","source_id":"application-26a24d46ac6f6ff6","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","pay_stubs"],"layer":"documented","quote":"Pay Stubs and/or Unemployment Compensation Income statements for the past three months (for applications April through December)","source_id":"fap-3bd68eeaad37e599","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Mail or bring to the Financial Counseling Office along with the following:"},{"kind":"in_person","detail":"Mail or bring to the Financial Counseling Office along with the following:"}],"layer":"documented","quote":"Mail or bring to the Financial Counseling Office along with the following:","source_id":"fap-3bd68eeaad37e599","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"You must apply within 240 days from the date of self-pay balance or application will be denied.","source_id":"fap-3bd68eeaad37e599","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"724.471.1472","layer":"documented","quote":"[724.471.1472](tel:+17244711472)","source_id":"fap-3bd68eeaad37e599","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":{"value":"Monday through Friday, 8 a.m. to 3:30 p.m.","layer":"documented","quote":"Application hours are Monday through Friday, from 8 a.m. to 3:30 p.m.","source_id":"fap-3bd68eeaad37e599","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"languages":{"value":["English","Spanish","German","Arabic"],"layer":"documented","quote":"The Financial Assistance policy, application form, and the plain language summary can be offered in English, Spanish, German, Arabic, and other languages upon request, by calling the Financial Counseling Department of the hospital at 724-471-1472 Monday through Thursday between 7:00 a.m. and 4:00 p.m.","source_id":"summary-a02b26904000940f","checked_on":"2026-10-13","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Indiana Regional Medical Center","IRMC Urgent Care Blairsville","IRMC Physician Group (IPG)","Punxsutawney Area Hospital","Punxsutawney Physician Group (PPG)","Punxsutawney Rural Health Clinics","Klain, Heasley, Nettleton – Blairsville","USACS – ER Providers and Hospitalists","ACMH Hospital","Glade Run Medical Associates","Indiana Total Therapy"],"layer":"documented","quote":"**Providers/Practices Covered by the Hospital’s FAP****:\n\n[](https://www.irmc.org/media/d925e3f7dbf84dda8b7ab2fe9e320433/irmc-financial-assistance-policy-provider-listing-oct-2025.docx)**Indiana Regional Medical Center\n\n**IRMC Urgent Care Blairsville\n\n**IRMC Physician Group (IPG)\n\n**Punxsutawney Area Hospital\n\n**Punxsutawney Physician Group (PPG)\n\n**Punxsutawney Rural Health Clinics\n\n**Klain, Heasley, Nettleton – Blairsville\n\n**USACS – ER Providers and Hospitalists\n\n**ACMH Hospital\n\n**Glade Run Medical Associates\n\n**Indiana Total Therapy","source_id":"fap-9e8a61952a27525f","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-3bd68eeaad37e599","kind":"hospital_web","url":"https://www.irmc.org/patients-and-visitors/financial-services/financial-assistance-program","title":"Financial Assistance Program","fetched_on":"2026-10-13","sha256":"3bd68eeaad37e599de4e90928e753a5584d374fda17e5fadbf1a316a2271bcc9","effective_date":null},{"id":"fap-9e8a61952a27525f","kind":"hospital_web","url":"https://www.irmc.org/media/d925e3f7dbf84dda8b7ab2fe9e320433/irmc-financial-assistance-policy-provider-listing-oct-2025.docx","title":"Providers Covered Under The Financial Assistance Plan","fetched_on":"2026-10-13","sha256":"9e8a61952a27525fa4dc47d5c4686a5cba3f1d1c071ff144036512c5b8432913","effective_date":null},{"id":"application-26a24d46ac6f6ff6","kind":"hospital_web","url":"https://www.irmc.org/media/ef9e23df27334847a239463713c20ad5/fap_application-2026.pdf","title":"**download the Financial Assistance Program application (PDF)**","fetched_on":"2026-10-13","sha256":"26a24d46ac6f6ff6bdb0a5fce86ef596db324b871da0c99af2f909e797d77f26","effective_date":null},{"id":"summary-a02b26904000940f","kind":"hospital_web","url":"https://www.irmc.org/media/957a182fd7b5442dac1f078aeb8296fc/irmc-fap-plain-language-summary-10-2025.pdf","title":"FAP Plain Language Summary","fetched_on":"2026-10-13","sha256":"a02b26904000940f604285c18af7c8f4a7aaa5008f7d3e4aa915c2077356b9df","effective_date":null}],"accuracy":null}