Lourdes was established by the Daughters of Charity in 1925 to
serve the people of this area, especially those in need. Today, we
continue our strong commitment to provide services to patients
regardless of their ability to pay.
Patients and/or Guarantors are responsible for payment of bills
for services provided by Lourdes. Lourdes has established the
Patient Financial Assistance Program to help
patients who meet the income and resources guidelines established
by Lourdes, and who are not eligible for any other
available program, such as Medicaid, Child Health Plus,
Family Health Plus, etc. It can also be used to assist with any
copays or deductibles of other programs. If we believe that you are
eligible for any other program, you must apply to that program and
receive in writing, an approval or denial before we can determine
if you are eligible for the Lourdes Patient Financial Assistance
Program. This requirement enables us to serve as many people as
possible with our limited funds. This program is available to the
extent Lourdes' resources allow.
A financial scale based on federal poverty level guidelines
determines your eligibility for the Patient Financial Assistance
Program. How much your Lourdes bill will be discounted depends on
how your gross income and resources compare with this financial
Scale is based on the Federal Poverty Level for 2013.
Gross income of individual or family is used.
Pregnant women are considered as two people.
If you are found eligible, your discount will apply to all
charges generated by Lourdes. Some services received at Lourdes are
provided by private physician groups, such as the services of a
Radiologist or Anesthesiologist, and are not covered because the
bill you receive is not a Lourdes bill. A Lourdes Patient Financial
Counselor will be happy to answer any questions and to help you
clarify your charges.
To Apply for Lourdes Patient Financial Assistance Program:
- Download and Complete the application
- Please include the names and dates of birth for all immediate
- Provide proof of total household income. Copies of pay stubs
for the most recent four week period, or a letter
from your employer stating monthly gross wages. Include
unemployment printout from website, Social Security benefits,
monthly pension or any other sources of monthly income.
If you are self-employed, please download, print
and complete a Financial Status
form to include with your Patient Financial Assistance Program
- We also need proof of any resources you may have.
Resources include checking/savings accounts, stocks, bonds and real
estate property other than your primary residency. We do not
include your home, tax deferred retirement or college savings
funds, or vehicles used by your immediate family.
- Mail the completed application and copies of required proofs to
the address at the bottom of the application. We will contact you
once your application has been reviewed. If your application is
denied, you may appeal this decision to the Health Care Access
If you wish to speak with a financial
counselor contact the cashiers office at Lourdes Hospital at
- You do not need to schedule an appointment to meet with a
Financial Counselor. You are welcome to walk in anytime between
8:00 AM and 4:00 PM, Monday - Friday to receive assistance
completing your PFAP application. Financial Counselors are
available at two locations:
- Lourdes Hospital, Financial Assistance Office, Ground
169 Riverside Drive, Binghamton, NY
- Lourdes Business Center, 33 Lewis Road, Binghamton, NY
- It takes up to 30 days to process your PFAP application.
- Applications are processed in the order in which they are
- If we have questions about your application, we will call
- If we do not have all the information necessary to process your
application, the application will be returned to you with a request
to provide additional information.
- You will receive written notification regarding the outcome of
your PFAP application.
- If you receive a denial letter, please feel free to contact Sue
at 607-798-5506 for information about the appeal process.
In accordance with our Mission and Values,
Our Lady of Lourdes Memorial Hospital, Inc. is committed to caring
for all people regardless of their ability to pay, with special
attention to those who are poor and vulnerable. Our Lady of Lourdes
Memorial Hospital, Inc.
offers financial counseling and
assistance to help address any financial
concerns patients or families may have regarding their
care. Our financial aid policies, which can be found here on
our website or by visiting our Patient Financial Assistance
office, located on the ground floor of Lourdes Hospital reflect Our
Lady of Lourdes Memorial Hospital, Inc.'s dedication to
working together with our patients in a compassionate and caring
manner to identify options for resolving their financial
obligations. Help is available by contacting the Financial
Assistance office at 607-584-5522, by emailing email@example.com, or in person
at any of our facilities.