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APPLICATION FOR FINANCIAL ASSISTANCE Illinois □ Good Samaritan Regional Health Center (Mt. Vernon) □ St. Mary’s Hospital (Centralia)
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Document Date: 2014-12-23 16:45:16

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File Size: 423,58 KB

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City

Jefferson City / Wentzville / St. Louis / /

Company

SSM Health - Patient Business Services / /

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Facility

SSM Cardinal Glennon Children’s Medical Center / Joseph Health Center / St. Anthony Shawnee Hospital / St. Francis Hospital / St. Clare Hospital / Mary’s Health Center / Joint St. Anthony Hospital / St. Anthony Hospital / Mary’s Hospital / SSM DePaul Health Center / Good Samaritan Regional Health Center / /

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IndustryTerm

insurance coverage / bank name / bank / Bank account statement / health insurance / financial assistance / machinery / healthcare / require purchasing health insurance / /

NaturalFeature

Mt. Vernon / /

Organization

Cardinal Glennon Children’s Medical Center / Responsible Party / SSM St. Joseph Health Center / Samaritan Regional Health Center / Medicare / /

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Position

Customer Service representative / Representative / /

Product

Financial Assistance Application / /

ProvinceOrState

Missouri / Wisconsin / Oklahoma / Illinois / /

SocialTag