Financial Assistance
English Documents
- CommonSpirit Health Mountain Region Financial Assistance Policy
- CommonSpirit Health Mountain Region Financial Assistance Plain Language Summary - Colorado
- Financial Assistance Required Documentation
Spanish Documents
- Política de ayuda financiera de CommonSpirit Health Mountain Region
- CommonSpirit Health Mountain Region Asistencia Financiera Resumen en Lenguaje Sencillo - Colorado
- Documentos necesarios para la ayuda financiera
Hospital Discounted Care - Colorado Only
English Documents
Spanish Documents
- Derechos del paciente de atención hospitalaria con descuento - Colorado
- Solicitud Uniforme para Atención hospitalaria al Descuento
Colorado Facilities Covered Providers
Patients with Insurance - Federal Poverty Level | Inpatient Care, Observation Visit, Same Day Surgery, Flight for Life | Outpatient Recurring Care | CommonSpirit Health Mountain Region Provider Fees |
---|---|---|---|
0-250% | $650 copay per visit | $50 copay per visit | 15% of charges |
251-299% | 10% of charges | 10% of charges | 25% of charges |
300-399% | 20% of charges | 20% of charges | 35% of charges |
*Insured patient's copayments cannot be lower than the 0-250% copay amounts.
Colorado Facilities Covered Providers
Uninsured - Federal Poverty Level | Inpatient Care, Observation Visit, Same Day Surgery, Flight for Life |
Outpatient Recurring Care | CommonSpirt Provider Fees |
---|---|---|---|
0-250% | $0 copay per visit | $0 copay per visit | 0% copay per visit |
251-299% | 10% of charges | 10% of charges | 25% of charges |
300-399% | 20% of charges | 20% of charges | 35% of charges |
*Uninsured patient's copayments cannot be lower than the 0-250% insured copay amounts.
Financial Assistance
English Documents
- CommonSpirit Health Mountain Region Financial Assistance Policy
- CommonSpirit Health Mountain Region Financial Assistance Plain Language Summary - Kansas
- Financial Assistance Required Documentation
Spanish Documents
- Política de ayuda financiera de CommonSpirit Health Mountain Region
- CommonSpirit Health Mountain Region Asistencia Financiera Resumen en Lenguaje Sencillo - Kansas
- Documentos necesarios para la ayuda financiera
Kansas Facilities Covered Providers
Federal Poverty Level | Inpatient Care, Observation Visit, Same Day Surgery, Flight for Life | Outpatient Recurring Care | CommonSpirit Health Mountain Region Provider Fees |
---|---|---|---|
0-150% | $650 copay per visit | $50 copay per visit | 15% of charges |
151-200% | 10% of charges | 10% of charges | 25% of charges |
201-250% | 20% of charges | 20% of charges | 35% of charges |
*Patient's copayments cannot be lower than the 0-150% copay amounts.
Financial Assistance
English Documents
- CommonSpirit Health Mountain Region Financial Assistance Policy
- Financial Assistance Plain Language Summary - Utah
- Financial Assistance Required Documentation
Spanish Documents
- Política de ayuda financiera de CommonSpirit Health Mountain Region
- Asistencia Financiera Resumen en Lenguaje - Utah
- Documentos necesarios para la ayuda financiera
Utah Facilities Covered Providers
Patients with Insurance - Federal Poverty Level | Inpatient Care, Observation Visit, Same Day Surgery, Flight for Life | Outpatient Recurring Care | Holy Cross Hospitals Provider Fees |
---|---|---|---|
0-250% | $650 copay per visit | $50 copay per visit | 15% of charges |
251-299% | 10% of charges | 10% of charges | 25% of charges |
300-399% | 20% of charges | 20% of charges | 35% of charges |
*Patient's copayments cannot be lower than the 0-250% insured copay amounts.