{"hospital":{"ccn":"671304","name":"ASCENSION SETON SMITHVILLE","city":"SMITHVILLE","state":"TX","zip":"78957","phone":"512-237-3214","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"],"layer":"documented","quote":"Additional income, asset and expense information may be requested upon review of the completed financial assistance application.","source_id":"billing-477e693115dc69cf","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":{"value":"Monday through Friday 8 am – 4:30 pm","layer":"documented","quote":"Financial counselors are available Monday through Friday 8 am – 4:30 pm. For additional assistance please contact a counselor associated to the location where services were performed.","source_id":"billing-477e693115dc69cf","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"languages":{"value":["English","Spanish","Chinese","Vietnamese","Korean","Arabic"],"layer":"documented","quote":"Translations of the Financial Assistance Policy, the Financial Assistance Policy application and instructions, and this plain language summary are available in the following languages on our website and upon request: English, Spanish, Chinese, Vietnamese, Korean, and Arabic.","source_id":"summary-2ee14d29ee788cf5","checked_on":"2026-10-10","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Ascension Seton Smithville"],"layer":"documented","quote":"• Ascension Seton Smithville","source_id":"fap-fc0e8efb255c54f6","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":"summary-a7863959fbb9c457","kind":"hospital_web","url":"https://healthcare.ascension.org/-/media/healthcare/financial-assistance/texas/txaus/plain-language-summary-dob/runningfile_txaus_english_dob_plain_language_summary.pdf","title":"[PDF] Ascension Seton Medical Group","fetched_on":"2026-10-10","sha256":"a7863959fbb9c457bf991716e1ce8a657161e0b241416b3244f5df462ceee3d2","effective_date":null},{"id":"billing-477e693115dc69cf","kind":"hospital_web","url":"https://healthcare.ascension.org/financial-assistance/texas-ascension-seton-financial-assistance/txaus-doctors-office-billing","title":"Manage your bill at Ascension Seton in Texas | Ascension","fetched_on":"2026-10-10","sha256":"477e693115dc69cffab6b81daba2118ba5facb6700809c60e3a3f41175b830ac","effective_date":null},{"id":"summary-2ee14d29ee788cf5","kind":"hospital_web","url":"https://healthcare.ascension.org/-/media/project/ascension/healthcare/legacy/markets/texas/seton/documents/financial-assistance/runningfile_eng_ascseton_plain-language-summary-of-fap.pdf","title":"ASCENSION SETON","fetched_on":"2026-10-10","sha256":"2ee14d29ee788cf52dfa44bb35097223f60bb0d70fc32dc1d6d8df3555be55c2","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}