Providers

Financial Assistance Application

Financial Assistance Application

medical bill payment

Do you have questions or need assistance with your health coverage?

Contact our financial counselors to determine what financial assistance opportunities are available for you. 

Information for Knox County Residents

In keeping with our mission to care for all patients, listed below are some guidelines to help you understand available financial assistance options. To provide you with other medical services, such as prescription coverage and services beyond Knox Community Hospital, we request that persons applying for financial assistance at KCH apply for Medicaid or other governmental options.

To meet the needs of patients in our community, we encourage those who may be eligible for health insurance plans offered through other means to do so. We will schedule procedures for underinsured patients or patients receiving partial financial assistance after receiving authorization from their insurance company. Please make arrangements for any expected balance payment amounts before having a procedure.

To accommodate individual needs, if a patient’s medical bills (after insurance payments) are three times their annual salary, our team will review their case to determine the best financial assistance option. Financial assistance is only available for medically necessary procedures.

NOTE: Please bring paystubs - three months, a full tax return for self-employed, and bank statements: month and date of service + two months prior when filling out/applying for financial assistance.

The KCH Financial Assistance Policy applies to fees for all services rendered at KCH facilities EXCEPT for fees for the following professional services and groups that are not employed or owned by KCH:

  • Laboratory and Pathology services provided by The Ohio State University 
  • Laboratory services provided by Lab Corp and other outside reference laboratories
  • Professional fees for services provided by the Pain Management Group
  • Professional fees for services provided by Riverside Radiation Oncology
  • Any ambulance, helicopter, or other medical transport services
Start the Process
Resources
Patient Financial Services
Certified Application Specialists

Knox Community Hospital
C/O Financial Counselors
1330 Coshocton Avenue
Mount Vernon, OH 43050

740.393.9631
740.393.9639
740.399.3831
740.326.3378
740.326.3368