{"hospital":{"ccn":"450573","name":"CHRISTUS JASPER MEMORIAL HOSPITAL","city":"JASPER","state":"TX","zip":"75951","phone":"409-384-5461","ownership":"Voluntary non-profit - Private","website_domain":"christushealth.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"300","layer":"documented","quote":"Any patient whose gross family income is at or below 300% of the FPL will be extended a full 100% charity care discount for any Uninsured Balance or Balance After Insurance on patient responsibility for Covered Services prior to the application of the Uninsured Discount, if applicable.","source_id":"fap-759dbf8a0e7dda6d","checked_on":"2026-10-10","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":["Medicaid","indigent programs"],"layer":"documented","quote":"or when the patient is enrolled in a Medicaid or indigent program but not in the state or county where the services were rendered;","source_id":"fap-759dbf8a0e7dda6d","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["photo_id","proof_of_income","social_security_letter","tax_return","pay_stubs","bank_statements"],"layer":"documented","quote":"YOU MUST PROVIDE AT LEAST 1 OF THE FOLLOWING: YOU MUST PROVIDE PROOF OF IDENTITY WITH Most recent and complete Income Tax Return AT LEAST 1 THE FOLLOWING: __3 most recent paycheck stubs __ Current Driver’s License __ Alien Registration __3 most recent checking/savings account statements __ Passport __State-Issued Identification Card __ Food Stamp or SSI/SSA/SSD award letter __If you report a $0 income, please attach a brief explanation of how you or the patient are meeting basic needs","source_id":"application-6ee205a8f6c645e2","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Mailing a written request to CBO Customer Service, 5101 N. O’Connor Blvd Irving, TX 75039; or 2900 North Loop West, Ste 1300 Houston TX 77092"},{"kind":"in_person","detail":"Delivered in person to the hospital admitting department."}],"layer":"documented","quote":"Completed applications, including all required information and documentation, should be submitted to the CHRISTUS Hospitals and CHRISTUS Clinics for eligibility determination. Completed applications may be: a. Submitted by mail to Customer Service using the address on the application; or b. Delivered in person to the hospital admitting department.","source_id":"fap-759dbf8a0e7dda6d","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"window_days_from_first_bill":null,"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"Under no circumstance will CHRISTUS Hospitals and CHRISTUS Clinics pursue an Extraordinary Collection Actions until 120 days after the date of the first post-discharge billing statement for the care at issue.","source_id":"fap-759dbf8a0e7dda6d","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"800-877-8623","layer":"documented","quote":"Calling Customer Service at 800-877-8623, Monday through Friday, 8 a.m. to 5 p.m. (central time)","source_id":"fap-759dbf8a0e7dda6d","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"hours":{"value":"Monday through Friday, 8 a.m. to 5 p.m. (central time)","layer":"documented","quote":"Calling Customer Service at 800-877-8623, Monday through Friday, 8 a.m. to 5 p.m. (central time)","source_id":"fap-759dbf8a0e7dda6d","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-759dbf8a0e7dda6d","kind":"hospital_web","url":"https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2026/financial-assistance-policy.ashx","title":"Financial Assistance Policy","fetched_on":"2026-10-10","sha256":"759dbf8a0e7dda6d42afdae5183304fa3240be50d8d7c91e18675b23bf3cfb04","effective_date":null},{"id":"application-6ee205a8f6c645e2","kind":"hospital_web","url":"https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2026/financial-assistance-application.ashx","title":"[PDF] Financial Assistance Application - CHRISTUS Health","fetched_on":"2026-10-10","sha256":"6ee205a8f6c645e2ff4a6a9c8fd6b8cf76b6a600c7f23a153806cc3fef89ef6c","effective_date":null},{"id":"summary-31155357c793f917","kind":"hospital_web","url":"https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2021plainlanguagesummaryhospitalenglish.ashx","title":"2021PlainLanguageSummaryHospitalEnglish.pdf","fetched_on":"2026-10-10","sha256":"31155357c793f91762f9201842de2a38ce733a0882e545604ab433d99193c0bc","effective_date":null},{"id":"fap-f01f296c29342a45","kind":"hospital_web","url":"https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2021-financialassistance-policy-english.ashx","title":"[PDF] CHRISTUS Health - FINANCIAL ASSISTANCE POLICY","fetched_on":"2026-10-10","sha256":"f01f296c29342a4583d89463340302abaf42f8e47389bb6d2fc87d6185fa15c5","effective_date":null}],"accuracy":null}