{"hospital":{"ccn":"451365","name":"ASCENSION SETON HIGHLAND LAKES","city":"BURNET","state":"TX","zip":"78611","phone":"512-715-3000","ownership":"Voluntary non-profit - Private","website_domain":"ascension.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"250","layer":"documented","quote":"Subject to the other provisions of this Financial Assistance Policy, Patients with income less than or equal to 250% of the Federal Poverty Level income (\"FPL\"), will be eligible for 100% charity care on that portion of the charges for services for which the Patient is responsible following payment by an insurer, if any, if such Patient determined to be eligible pursuant to presumptive scoring (described in Paragraph 5 below) or submits a financial assistance application (an \"Application\") on or prior to the 240th day after the Patient’s first discharge bill and the Application is approved by the Organization.","source_id":"fap-fc0e8efb255c54f6","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":null,"state_programs":null},"apply":{"form_url":{"value":"https://ascension.forms.r1rcm.com/seton/fa","layer":"documented","quote":"[Start Application](https://ascension.forms.r1rcm.com/seton/fa)","source_id":"fap-8648b5f2cc442cd9","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["proof_of_income","social_security_letter","tax_return","pay_stubs","bank_statements","medicaid_denial"],"layer":"documented","quote":"Along with the application, you will need to provide verification of your household’s income and verification of all assets owned by any household member. Examples of proof of income and assets include: • Copies of 3 most recent paystubs from employer • Copies of most recent yearly tax return (if self-employed, include all schedules) • Social Security and/or Pension Retirement Award Letter • Parent or guardian’s most recent yearly tax return, if applicant is a dependent listed on their tax form and under the age 25 • Copy of receipt of unemployment benefits • Approval/denial of eligibility for Medicaid and/or state-funded medical assistance • Other income validation documents Examples of proof of assets include: • Current bank statements (checking and savings accounts) from last 3 months • Investments, including stocks and bonds • Trust funds • Money market accounts • Mutual fund","source_id":"application-6fcc6e22469682ec","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Patient will be eligible for up to 100% financial assistance if Patient submits the Application after the 240th day after the Patient’s first discharge bill, but then the amount of financial assistance available to a Patient in this category is limited to Patient’s unpaid balance after taking into account any payments made on Patient’s account.","source_id":"fap-fc0e8efb255c54f6","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"512-324-1125","layer":"documented","quote":"Help and/or additional information regarding Ascension Seton’s financial assistance policy is available by contacting Patient Financial Services (PFS) Customer Service at [512-324-1125](tel:5123241125) or [800-749-7624](tel:8007497624), by calling the facility where you received care or in person in Patient Access at any of our facilities.","source_id":"fap-8648b5f2cc442cd9","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Arabic","Chinese (Simplified)","Chinese (Traditional)","Farsi","French","German","Gujarathi","Hindi","Japanese","Korean","Portuguese","Russian","Spanish","Tagalog","Urdu","Vietnamese"],"layer":"documented","quote":"* [English](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_english_financial-assistance-policy.pdf)\n* [Arabic](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_arabic_financial-assistance-policy.pdf)\n* [Chinese (Simplified)](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_chinese_simplified_financial-assistance-policy.pdf)\n* [Chinese (Traditional)](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_chinese_traditional_financial-assistance-policy.pdf)\n* [Farsi](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_farsi_financial-assistance-policy.pdf)\n* [French](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_french_financial-assistance-policy.pdf)\n* [German](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_german_financial-assistance-policy.pdf)\n* [Gujarathi](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_gujarathi_financial-assistance-policy.pdf)\n* [Hindi](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_hindi_financial-assistance-policy.pdf)\n* [Japanese](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_japanese_financial-assistance-policy.pdf)\n* [Korean](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_korean_financial-assistance-policy.pdf)\n* [Portuguese](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_portuguese_financial-assistance-policy.pdf)\n* [Russian](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_russian_financial-assistance-policy.pdf)\n* [Spanish](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_spanish_financial-assistance-policy.pdf)\n* [Tagalog](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_tagalog_financial-assistance-policy.pdf)\n* [Urdu](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_urdu_financial-assistance-policy.pdf)\n* [Vietnamese](/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_vietnamese_financial-assistance-policy.pdf)","source_id":"fap-8648b5f2cc442cd9","checked_on":"2026-10-10","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Ascension Seton Bastrop","Ascension Seton Cedar Park","Ascension Seton Edgar B. Davis","Ascension Seton Hays","Ascension Seton Highland Lakes","Ascension Seton Medical Center Austin","Ascension Seton Northwest","Ascension Seton Smithville","Ascension Seton Southwest","Ascension Seton Williamson","Dell Children's Medical Center","Dell Seton Medical Center at The University of Texas"],"layer":"documented","quote":"These financial assistance documents cover services provided at:\n\n* Ascension Seton Bastrop\n* Ascension Seton Cedar Park\n* Ascension Seton Edgar B. Davis\n* Ascension Seton Hays\n* Ascension Seton Highland Lakes\n* Ascension Seton Medical Center Austin\n* Ascension Seton Northwest\n* Ascension Seton Smithville\n* Ascension Seton Southwest\n* Ascension Seton Williamson\n* Dell Children's Medical Center\n* Dell Seton Medical Center at The University of Texas","source_id":"fap-8648b5f2cc442cd9","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-8648b5f2cc442cd9","kind":"hospital_web","url":"https://healthcare.ascension.org/financial-assistance/texas-ascension-seton-financial-assistance","title":"Financial assistance at Ascension Seton in Texas | Ascension","fetched_on":"2026-10-10","sha256":"8648b5f2cc442cd9f929ff894653c4eb8963a53fe0f88ac1f5a493286b82445c","effective_date":null},{"id":"application-6fcc6e22469682ec","kind":"hospital_web","url":"https://healthcare.ascension.org/-/media/healthcare/financial-assistance/texas/txaus/fap-application/runningfile_txaus_english_financial-assistance-application.pdf","title":"Financial Assistance Application","fetched_on":"2026-10-10","sha256":"6fcc6e22469682ec80167ed63b3925529966e76ac7fe3ced8767510f708c04a4","effective_date":null},{"id":"billing-a324e810b0be901e","kind":"hospital_web","url":"https://healthcare.ascension.org/billing/bill-pay-online-texas-ascension-seton","title":"Official Bill Pay Online | Ascension Seton | Austin, TX | Ascension","fetched_on":"2026-10-10","sha256":"a324e810b0be901e970afd26d3bb3c3ffa1fcffc9743a9a0f2d57dda022f6b1e","effective_date":null},{"id":"fap-23ca6827ff56e422","kind":"hospital_web","url":"https://healthcare.ascension.org/financial-assistance","title":"Financial Assistance | Ascension","fetched_on":"2026-10-10","sha256":"23ca6827ff56e422f4a7866a80645d6aeddbcb07981df8d5fa809e8fb63708f8","effective_date":null},{"id":"fap-fc0e8efb255c54f6","kind":"hospital_web","url":"https://www.ascension.org/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_english_financial-assistance-policy.pdf","title":"English","fetched_on":"2026-10-10","sha256":"fc0e8efb255c54f6456ba74f84f37e5d9b61bf46c0b8e93aa59c832a3dae3fc8","effective_date":null},{"id":"fap-18877f02ce743e12","kind":"hospital_web","url":"https://www.ascension.org/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_arabic_financial-assistance-policy.pdf","title":"Arabic","fetched_on":"2026-10-10","sha256":"18877f02ce743e12d9a356b53a2129e786ab4da69c1d18db6d88e5f1b13f18b1","effective_date":null},{"id":"fap-9de9c3014173040d","kind":"hospital_web","url":"https://www.ascension.org/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_chinese_simplified_financial-assistance-policy.pdf","title":"Chinese (Simplified)","fetched_on":"2026-10-10","sha256":"9de9c3014173040d2d4489211e5b04ca1d64f5414d53bca4be100f63f0082d2b","effective_date":null},{"id":"fap-0bfe50832a9ebd14","kind":"hospital_web","url":"https://www.ascension.org/-/media/healthcare/financial-assistance/texas/txaus/fap/runningfile_txaus_chinese_traditional_financial-assistance-policy.pdf","title":"Chinese (Traditional)","fetched_on":"2026-10-10","sha256":"0bfe50832a9ebd14d68103f2159244279d756fd0d2159e98b4788966e5093e87","effective_date":null}],"accuracy":null}