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If you are hospitalized, you will receive an itemized statement for your hospital room, meals, nursing care, laboratory services and other related services. You will also receive a bill from any physician involved in your care.

Customer service ‚Äčrepresentatives are available Monday- Friday 8 a.m.–4:15 p.m., excluding holidays, to assist you with the financial aspect of your care. You may contact them at 330-438-6321 or 800-900-6321. They can also be emailed at PA@Aultman.com.

You are responsible for payment of your hospital bill. For your convenience, we accept cash, checks, Visa™ & MasterCard™ credit cards.

Financial Assistance
Financial counseling is available for patients to obtain an estimate of charges for services and make payment arrangements. You can contact our Financial Counselor at 330-684-4716. For more information, please click here to view the Aultman Orrville Hospital Financial Assistance policy, and here to view the Aultman Orrville Hospital Financial Assistance summary.
 
HCAP
Aultman Orrville Hospital is committed to serve and assist those without medical insurance. Under the Ohio Hospital Care Assurance Program (HCAP), Aultman Orrville offers basic, medically necessary hospital-level services free of charge to individuals who are residents of Ohio and whose income is at or below the Federal Poverty Income Guidelines. Please keep in mind when calculating your family size that yourself, your spouse and all children, natural and adopted, under the age of 18 who live in the home or outside the home are included. Unfortunately, stepchildren cannot be included. 

Review the guidelines for free care. For services delivered on or after Jan. 13, 2018:

Family Size 2018 Income Guidelines
1 $12,140
2 $16,460
3 $20,780
4 $25,100
5 $29,420
6 $33,740
7 $38,060
8 $42,380

 
Add $4,180 for each additional person if the family unit has more than eight members.

Click here to review additional 2018 financial assistance eligibility criteria.

How to Apply

In order for the application to be processed, you must: 

- Complete an entire HCAP application, including family and income information. En Español.
- Sign and date the application.
- Return the completed application to: 

Financial Counselors
Aultman Orrville Hospital
832 S. Main St. 
Orrville, OH. 44667
 
HCAP Covered Services
Please note that the HCAP program only covers services billed by Aultman Orrville Hospital. The program does not cover elective or cosmetic surgery, organ transplants, patient convenience items, take-home pharmacy charges, transportation fees, physician and anesthesia charges. 

Collections Policy
Aultman Orrville Hospital has implemented a collection process for the accounts receivable of patients receiving hospital services that supports the business needs of the hospital and, together with the Financial Assistance Policy, is intended to comply with applicable federal, state and local laws, including Section 501(r) of the Internal Revenue Code of 1986. Click here to review the policy

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