Qualifications for Financial Assistance

We, at Pawnee Valley Campus, realize that financial concerns can add to the stress of any medical situation. Financial assistance will be made available to any eligible patient. Each case is handled individually, based on the following eligibility guidelines:

*Applicant must agree to participate in a review for qualification for coverage through any
applicable public program such as Medicaid or Medikan
*Payment from all other sources must be exhausted
*Assistance is applied only to the self-pay portions of a patient’s bill
*Patient must reside in our service area and meet residency requirements
*Financial need is based on income guidelines established by the Federal Government
*Financial assistance will be provided only for those procedures considered to be medically
*Applicant must provide copies of income tax return and prior three months pay stubs;
additional information may be requested
*Applicant must complete Hays Medical Center’s Financial Assistance Application form
*For clinic accounts, only income and family size will be used for determining eligibility.

If you feel you may qualify for financial assistance, or if you have any questions, please contact one of our Financial Counselors at the following number 785.623.5100.