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Financial Assistance Letter
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The William W. Backus Hospital provides financial assistance for certain qualified patients who are unable to pay all or part of their bill for inpatient, outpatient and emergency services rendered at the hospital.
If you are coping with a financial hardship and are facing debts owed to The William W. Backus Hospital, financial assistance such as free care or a sliding scale discount may be available to you. The financial counseling process will indicate what options exist to assist you with your outstanding balance.
Financial assistance applies to Backus Hospital bills only. It does not apply to Radiologists, Pathologists, Anesthesiologists or other professional services involved in your care that are billed separately.
To apply please submit the attached Application for Financial Assistance and the following verifications of income information:
Most recent Federal tax return and W-2
Most recent 3 payroll checks
Copies of unemployment checks
Copies of any pension, alimony, child support or other sources of income
Copies of Social Security earnings, if any
Any other pertinent information.
Proof of income or earnings is required with application or the application will not be considered.
Please allow 3 to 4 weeks for processing time; you will be notified by mail of the outcome of your application.
If you have any questions please contact Customer Service:
Monday
thru Friday, 9:00 am to 4:00 pm
(860)
823-6394 / Fax: (860) 892-6902.