Financial Assistance may be available to patients who do not qualify for state or federal assistance.
INTEGRIS Health recognizes there are times when patients may have difficulty paying for services received. Financial assistance may be available to patients who do not qualify for state or federal assistance.
In most cases, patient’s that fall between 0-150% of Federal Poverty Guidelines based on total household income may have a 100% financial assistance discount processed *subject to income verification/documentation requirements). In certain cases, other discounts ranging from 79-97%. may apply if the patient’s total household income exceeds these thresholds. Further eligibility and assistance information, a copy of Financial Assistance Policy, the Financial Assistance Application form and a plain language summary for the Financial Assistance Policy (English, Spanish or Vietnamese) are available by contacting the INTEGRIS Health Business Office at (855) 409-5458.
Financial assistance is generally determined by your total household income as compared to the Federal Poverty Level. Patients with family incomes less than or equal to 150% of the Federal Poverty Level are eligible for a 100% charity care write-off of the portion of the charges for which you are responsible. Patients with family incomes ranging from 151% to 300% of the Federal Poverty Level, are eligible for discounted rates on a sliding scale. To qualify for financial assistance, patients must complete a financial assistance application, provide requested documents to verify financial need and meet other eligibility criteria. Patients who are eligible for financial assistance will not be charged more for eligible care than the amounts generally billed to patients who have insurance coverage covering such care. You may be asked if you have insurance of any kind to help pay for care. You may be asked to show that insurance or a government program will not pay for care.
Financial Assistance is only available for health services that are both medically necessary and generally available and provided by INTEGRIS Health. These terms are defined in the Financial Assistance Policy.
You must apply for financial assistance by completing a written application and providing requested supporting documentation, as described in the Financial Assistance Policy and the Financial Assistance Policy application. The Financial Assistance Policy application instructions will be made available upon patient request at the time of service.
If a patient wishes to apply for financial assistance after the medical services have been provided, the Financial Assistance Policy application instructions may be accessed and printed directly from this page.
Patients may also request a copy of the Financial Assistance Policy application instructions by mail. To request a copy of the documents by mail, patients should call the INTEGRIS Health Business Office at (855) 409-5458.
For help with a Financial Assistance Policy application, you may contact:
INTEGRIS Health Business Office
5300 N Independence Avenue Suite 130
Oklahoma City, OK 73112
(855) 409-5458
After the completed application has been reviewed, a determination of eligibility or non-eligibility will be made, and you will be notified of the decision.
Copies of the Financial Assistance Policy and application form are available at integrisandme.com and the 5300 N Independence Avenue Suite 130
Oklahoma City, OK 73112.
Free copies of the Financial Assistance Policy and application also can be obtained by mail by calling the INTEGRIS Business Office at (855) 409-5458.
Additional information about the Financial Assistance Policy is also available upon request in any admissions area and at the INTEGRIS Health Business Office, 5300 N Independence Avenue Suite 130, Oklahoma City, OK 73112 or by telephone at (855) 409-5458.
If you do not qualify for financial assistance under the Financial Assistance Policy, you may qualify for other types of assistance. For more information, please contact the INTEGRIS Health Business Office, 5300 N Independence Avenue Suite 130, Oklahoma City, OK 73112 or by telephone at (855) 409-5458.
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