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PATIENT INFORMATION:
BILLING AND FINANCIAL ASSISTANCE POLICY
Overview of MMS Financial Assistance Policy: Mercy Medical Center (MMC) provides and promotes
health services for the people of Baltimore
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How to fill out billing and financial assistance

How to fill out billing and financial assistance
01
To fill out billing and financial assistance, follow these steps:
02
Gather all necessary information and documents such as your personal information, income details, and medical bills.
03
Contact the billing department of the organization or hospital where you received the services.
04
Request a billing and financial assistance application form or access it online if available.
05
Fill out the application form accurately and provide all required information.
06
Attach the supporting documents such as proof of income, medical bills, and any additional requested documentation.
07
Review your completed application form and documents to ensure everything is accurate and complete.
08
Submit the application form and all supporting documents to the billing department.
09
Follow up with the billing department to confirm receipt of your application and inquire about the review process.
10
If required, provide any additional information or clarification requested by the billing department during the review process.
11
Await a response from the billing department regarding your eligibility for financial assistance or any necessary payment arrangements.
12
If approved for financial assistance, review the terms and conditions provided by the billing department and fulfill any obligations outlined.
13
If less favorable outcomes occur, such as denial of financial assistance or inability to meet payment obligations, consider exploring other options such as negotiating a payment plan or seeking additional financial assistance programs.
14
Maintain copies of all submitted documents, correspondence, and agreements for future reference and documentation.
15
Remember, it's important to contact the billing department for specific guidance and any additional instructions they may have.
Who needs billing and financial assistance?
01
Billing and financial assistance is often needed by individuals who:
02
- Do not have medical insurance coverage
03
- Have high medical bills that are difficult to manage
04
- Experience financial hardship and struggle to afford necessary medical services
05
- Are uninsured or underinsured
06
- Have limited income or are living below the poverty line
07
- Are facing unexpected medical expenses and require assistance in managing the payments
08
- Are eligible for government-sponsored healthcare programs but need help navigating the application process
09
If you find yourself in any of these situations or require financial support for medical expenses, you may benefit from billing and financial assistance programs.
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What is billing and financial assistance?
Billing and financial assistance is a system designed to help individuals and organizations manage their financial obligations and receive assistance when needed.
Who is required to file billing and financial assistance?
Anyone who is seeking assistance with their billing or financial obligations may be required to file for billing and financial assistance.
How to fill out billing and financial assistance?
To fill out billing and financial assistance, individuals must provide information about their financial situation, including income, expenses, and any outstanding debts.
What is the purpose of billing and financial assistance?
The purpose of billing and financial assistance is to provide support to individuals who are struggling to meet their financial obligations due to various reasons.
What information must be reported on billing and financial assistance?
Information such as income, expenses, debts, assets, and any other relevant financial information must be reported on billing and financial assistance.
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