Medical Financial Services
Who is eligible for Saint Alphonsus' assistance?
All patients, regardless of race, creed, gender, age, or national origin, may apply for financial assistance from Saint Alphonsus either in advance of or after receiving covered services.
Eligibility is determined on an individual basis, taking into account factors such as family size, income, assets, and insurance status.
For financial questions and assistance after your hospital or clinic visit, please contact our Customer Service Representatives:
Local: 208-367-2130
Toll Free: 1-866-626-7272
Once you have completed the Saint Alphonsus Financial Assistance Form, send it along with the supporting documentation to:
Saint Alphonsus Patient Business Services - Financial Services
20555 Victor Parkway
Livonia, MI 48152
Documents
English
- Financial Assistance Application
- Financial Assistance to Patients (Policy)
- Financial Assistance Summary
Español
- Financial Assistance Application - Spanish
- Financial Assistance Policy - Spanish
- Financial Assistance Summary - Spanish
Other Languages
- Arabic (Eurbaa)
- Burmese (Myanmar)
- Chinese (Zhongwén)
- Farsi
- French
- Financial Assistance Application - French
- Financial Assistance Policy - French
- Financial Assistance Summary - French
- Japanese (Nihongo)
- Karen
- Kurdish
- Nepali (Nepali)
- Russian (Russkiy)
- Serbo-Croatian (Srpsko-Hrvatski)
- Swahili (Kiswahili)
- Urdu
- Vietnamese (Tiếng Việt)