Financial Assistance

Financial Assistance Policy

Pioneer Memorial Hospital & Health Services has an extensive Financial Assistance Policy where emergency and other medically necessary services may be forgiven based upon financial need. We will figure out how much you owe by looking at things like your income or other resources. To qualify for financial assistance, your household income must be at or below 350 percent of the federal poverty level. This assistance can range from a reduction in the amount of the balance outstanding up to complete forgiveness of the balance outstanding. The right to apply for financial assistance consideration begins on the date of service and extends through the 240th day after the first billing statement is sent to the patient or guarantor. However, patients and guarantors are encouraged to submit their Financial Assistance Application as soon as possible.

You may view a copy of the Summary of Financial Assistance Policy and the Financial Assistance Policy by clicking on the links below.

Summary of Financial Assistance Policy

Financial Assistance Policy

To determine if you are eligible for financial assistance, a financial assistance application must be submitted along with required documentation, such as income tax forms and pay stubs. A financial assistance application can be obtained by clicking on the link below.

Financial Assistance Application

If you have questions or need assistance completing the application, please contact Patient Financial Services at 605-326-5161 ext. 3064.

Application can be filled out and return to:

Pioneer Memorial Hospital & Health Services Patient Financial Services PO Box 368, Viborg, SD 57070-0368

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