If payment of your Roper St. Francis Healthcare expenses could create a financial hardship for you, our staff will work with you to apply for financial assistance.

Applications will be processed, and approval will be determined based upon specific, pre-established criteria. If approved for financial assistance, your bill with Roper St. Francis Healthcare will be reduced or forgiven. Roper St. Francis Healthcare will not discriminate in the determination of uncompensated care eligibility on the basis of race, color, creed, sex, age, or handicap.

Criteria for Financial Assistance
Before financial assistance is approved, you must exhaust all other sources of payment, including insurance, public assistance, litigation, or third party liability. Financial assistance determination is primarily based upon family income in relation to federal poverty guidelines. We may review any additional assets (e.g., home, bank account, stocks), supplementary financial hardship funds you receive. To qualify for financial assistance, your services must be non-elective, medically necessary care.

How to Apply for Financial Assistance

If you are an inpatient in one of our facilities and do not have insurance, a Financial Counselor will visit you in your hospital room to discuss Financial Assistance.

If you are not an inpatient, or have already been discharged and would like to discuss Financial Assistance, please call our office:

Roper Hospital patients	(843) 724-8322
Bon Secours St. Francis Hospital patients	(843) 402-1779
Roper St. Francis Medical Center Berkeley patients	(843) 899-7700 ext. 5001

A financial counselor will advise you on your options and investigate other sources that might provide financial assistance. The financial counselors will assist you in completing the necessary applications for Medicaid, MIAP, etc. If you are at one of our facilities and would like to talk to a Financial Counselor, please go to the Admitting Department and they will direct you to a financial counselor.

Complete a financial assistance application and submit it with one of the required documents listed below. Applications may be picked up at one of the Admitting Departments.

• Copy of last year's Federal Income Tax Return and all schedules
• Copy of last year's W-2 form(s)
• Copy of most recent paycheck stubs or a statement from your employer
• Copy of most recent bank statements (e.g., savings, checking, money market, IRA, 401K, etc.)
• Copy of unemployment, disability compensation benefits statements
• Copy of social security or pension benefits income
• Copy of government assistance notices (including Department of Health & Human Services).