Financial Assistance Services

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If you qualify for partial support from Trinity Health System, learn the amounts generally billed/reimbursed for services at Trinity Health System.

Trinity Health System understands that paying for emergency and/or medically necessary medical care can be difficult, particularly for patients who lack health insurance. As part of our ongoing commitment to our patients, CHI works hard to help our patients address their financial responsibilities in a way that is fair and sensitive to their circumstances. We have instituted a program designed specifically to help those who find themselves in financial distress.

The Program

The CHI Financial Assistance Policy (available in multiple languages) applies to uninsured/underinsured patients who come to our facilities for treatment. This policy provides financial relief to patients who qualify based on a comparison of their financial resources and/or income to Federal Poverty Guidelines. The program is designed specifically for emergency and/or medically necessary medical patients whose household financial resources and/or income are at or below 400 percent of the Federal Poverty Level.

To qualify for any assistance, uninsured/underinsured patients will be asked to complete a CHI Financial Assistance Application (available in multiple languages) which includes information relating to household income and expenses.

Click Here for Amount Generally Billed

Financial Assistance Application 

Summary of Financial Assistance Policy

Governance Policy (Billing & Collections)

Governance Policy (Financial Assistance)

Governance Policy (Billing & Collections) in Spanish

Governance Policy (Financial Assistance) in Spanish

Financial Assistance Application in Spanish

Summary of Financial Assistance Policy in Spanish

Covered and Non Covered Physicians/Providers

Trinity Health System will not balance bill: any patient for services related to the treatment of COVID 19

During this difficult time we are committed to working with our patients to establish and approve an appropriate payment plan based on the amount due and the patient’s financial status, should you have any questions or concerns regarding your bill, please contact:

Twin City Medical Center
Eligibility and Enrollment Services
819 N. First St., Dennison, OH 44621
Phone: 844-428-7500
Fax: 740-922-7412