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Financial Assistance

What if I don’t have insurance and I don’t qualify for financial assistance?

HackensackUMC Mountainside offers reduced rates to patients without insurance who don’t qualify for financial assistance. These rates are based on those paid by Medicare. Please contact the Billing Department at 1-866-763-7714 for further information.

What is financial assistance?

The State of New Jersey defines financial assistance as Charity Care or Reduced Charity Care for patients who have income and asset limits that fall within the set guidelines.

What services are eligible for financial assistance?

All inpatient and outpatient services provided by HackensackUMC Mountainside that are defined as medically necessary by the State Department of Health. Physician charges are not eligible for financial assistance.

Who can apply for financial assistance?

The state has defined that all patients who are residents of the State of New Jersey are eligible to be screened to receive financial assistance. You may apply for a relative or as a guardian to a patient. Applicants with assets that can readily be converted to cash of over $7,500 per individual or $15,000 per family will not be eligible for assistance.

Is it possible to set up a payment plan?

HackensackUMC Mountainside will work with patients who request payment plans. The payment plan may not exceed six months and the patient must pay at least $25 per month.

What if I can’t make my payments?

When a patient is delinquent in his or her payments, a notice will be sent to the patient offering to discuss the bill and determine if financial assistance or a new or revised payment plan is needed. Patients who fall behind in their payments and do not arrange with the Financial Counseling Office or the Customer Service Office for an alternate payment plan will have their accounts turned over to a collection agency. This will occur when no payment has been received for 120 or more days.

How do I apply for assistance?

You may apply by calling the Billing Department at 1-866-763-7714.

What time may I call for an appointment?

You may call from 9:00 a.m. to 3:00 p.m., Monday through Friday.

When can I apply?

We encourage all applicants to apply as near to the time of service as possible. All patients must apply for financial assistance at the time of service if emergent and prior to service if non-emergent. No appointment is necessary.

What services are not covered?

Some of the services not covered are: physician fees, elective cosmetic surgery, telephone, television, patient convenience services, labor and delivery charges and certain other services. If you have any questions, call the Billing Department at 1-866-763-7714.

Do I need to bring anything with me when I apply?

You will be asked to show proof of income and residence. You will be asked to bring as many of the following that apply to your situation:


1. Identification: Acceptable forms of identification for a patient and each dependent (spouse, minor children, and full-time students up to 23 years old) include:

  • Valid driver’s license
  • Social security card
  • Birth certificate
  • Valid passport/resident alien card (green card)
  • Employee ID card

2. Proof of residency one month prior to service date. Acceptable forms of New Jersey residency include:

  • Driver’s license issued at least 1 month prior to service date
  • Utility bills
  • Identification card with address
  • Apartment lease/house deed
  • Letter from person providing shelter

3. Health Insurance Verification: Copy of your and your spouse’s health insurance ID Card(s). The New Jersey Hospital Care Program is based on need. The following information is required to determine eligibility. All information is kept strictly confidential.

4. Income and assets: Documentation for all members immediately prior to service date.

Proof of income includes:

  • Pay stub
  • Social security/SSI/pension award letters
  • Welfare/disability/unemployment stubs

Proof of assets includes:

  • Checking/savings account statements
  • Stocks and bonds
  • Real estate equity (not primary residence)

Is there any system in place for a patient to discuss and settle any potential problems that arise from this process?


Appeals or challenges must be put in writing and addressed to:
DIRECTOR OF SERVICES, Health Care for the Uninsured Program, State of New Jersey Department of Health, Room 403, CN 360 Trenton, NJ 08625-0360