Patient Guide

Help for the Uninsured and Underinsured

Patient Financial Assistance Program

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, and billed by Lourdes. Lourdes has established the Patient Financial Assistance Program to help patients who meet the income guidelines established by Lourdes. 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, we will assist you with exploring your options through the Health Insurance Exchange. This 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 compares with this financial scale.

 2015 Poverty Level Guidelines

  • Scale is based on the Federal Poverty Level for 2015.
  • 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, except for non-emergency services provided to patients with insurance who have been notified in writing that Lourdes does not participate in their insurance plan. 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 - just call (607) 584-5522.

To Apply for Lourdes Patient Financial Assistance Program:

  1. Download and Complete the application (PDF).
  2. Please include the names and dates of birth for all immediate household members.
  3. 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 provide a signed copy of your tax return from the previous year.
  4. 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 Committee.

If you wish to speak with a financial counselor, please call 607-584-5522. 

Please note:

  • 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, Main Floor, 
      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 received.
  • If we have questions about your application, we will call you.
  • 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 info@lourdes.com, or in person at any of our facilities.

 

LOURDES Hospital | 169 Riverside Drive • Binghamton, NY 13905 | Phone: 607-798-5111 / Directory | Email: info@lourdes.com