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Financial Assistance Policy & Procedure

Picture of a paper that says "EXPLANATION OF BENEFITS" , a calculator, keyboard, and a pen lying over the paper.

"No one will be denied access to services due to an inability to pay; there is a discounted / sliding fee schedule available based on family size and income."

It is the policy of Dallas County Medical Center to provide healthcare to the uninsured or the underinsured patients of our service area.

The financial assistance program is designed to assist patients who cannot pay for all or part of their care.

Upon approval by committee, it is to be applied to any self-pay portion of a patient's account.

Certain status changes (loss of job or death of a spouse) can affect the status of an account where financial assistance has been denied in the past.

Please re-apply for financial assistance if you believe you have had a significant change in your financial status.

A complete application including one of the following: a current W-2, 1099, the most recent tax return, check stub, bank statement showing direct deposit of SSI or social security check is required to complete the Financial Assistance process. Patients who exceed the income guidelines may be reconsidered when extenuating circumstances apply.

All Financial assistance Applications must be turned in to the Business Office within 10 working days.

Process including approval by committee, if needed.

Application is good for one (1) year.

2024 - Financial Assistance Policy and Procedures

2024 - Financial Assistance Application

2024 - Sliding Fee Schedule

Notice To Post Protection Against Surprise Bills

Notice To Post Right To Receive A GFE

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