Find a Physician
Giving To Your Hospital
Valley Physician Enterprise
Find a Physician
Find by Name or Specialty
Distance (in miles):
Hampshire Memorial Hospital
363 Sunrise Boulevard
Page Memorial Hospital
200 Memorial Drive
Shenandoah Memorial Hospital
759 South Main Street
War Memorial Hospital
1 Healthy Way
Warren Memorial Hospital
1000 N. Shenandoah Avenue
Winchester Medical Center
1840 Amherst Street
Urgent Care – Front Royal
120 North Commerce Avenue
Urgent Care – Winchester
607 E. Jubal Early Drive
Urgent Care – Martinsburg
97 Administrative Drive
33820 Old Valley Pike, Suite 2
All Treatments & Services
Heart & Vascular Services
Wellness & Fitness Services
Women & Children
Select a letter to view treatments and services
Maps & Directions
HealthAware Risk Assessments
Healthy Weight Options
Spirit of Women
Medical Staff - Physician Opportunities & Credentialing
Family Practice Residency Program
« Home to Valley Health
Find a Physician
Calendar of Events
» Patient & Visitors »
Valley Health recognizes that not all uninsured or underinsured patients meet eligibility requirements for federal, state, or local entitlement programs or the Virginia Indigent Health Care Trust Fund (VIHCTF). Therefore, in addition to assisting patients in determining eligibility for these programs and consistent with its mission and values, Valley Health offers charity assistance to eligible individuals and families.
Assistance for each individual episode of care has to be requested separately. Completed paperwork must be returned in a timely manner, typically within 30 calendar days.
Assistance is generally based on income levels at the time of the episode of care. There may be situations where the income is based on the time of request. (see below for
Certain medical procedures are excluded; some examples include certain types of cosmetic surgery, bariatric surgery and other procedures not deemed medically necessary. International patients are not eligible for charity assistance.
Valley Health’s charity assistance may include certain physicians’ charges, as well as hospital services. Valley Health does not have the authority to waive any charges from physicians or other heath professionals who are not employed by Valley Health.
For your information: uninsured discount of 30% (patients with no insurance may be eligible for a 30% discount off of total charges).
A) Patients may request a determination for charity assistance prior to treatment, throughout the course of treatment and/or up to the resolution of the account through the Billing/Accounts Receivable process. Accounts that have reached the bad debt status of collections, and therefore are being pursued by a third-party agency or through our legal collection processes, shall not be considered for charity assistance.
B) Patients must complete a
Financial Information Sheet (FIS)
for the facility within Valley Health for which they are applying for assistance and provide supporting documentation of income. Acceptable documentation includes:
Copies of paychecks or bank statements showing EFT deposits, validating income for the month of service/discharge plus 2 prior months
Copies or stubs of Social Security, pension, disability, workers compensation or unemployment checks
Verification of alimony and/or child support payments for three months
In rare situations, signed federal or state tax returns may be substituted for income verification. Also, notarized letters from their employer may be used with approval.
Letter of support if the basic living needs and expenses are being provided by another party, contingent on verification (i.e. a notarized statement)
C) If the FIS is not filled out completely or income documentation is not returned within 30 days of application, charity assistance may not be approved. The financial counselor assigned to the account will evaluate the documentation for completeness and will work with the applicant to secure any of the documentation that is missing.
D) Once all documentation is complete, the financial counselor will compute the income, family size of the applicant and other relevant information. If the applicant falls within the below criteria, all accounts within the timeframe specified in the guidelines will be written off to Valley Health charity and a letter will be sent outlining the approved assistance.
Patients with Gross Annual Family Income Less Than or Equal to 100% of Guidelines
A) Patients whose gross annual family income is less than or equal to the federal non-farm poverty levels as published in the then current year Federal Register are eligible and encouraged to apply for Valley Health charity assistance. Income or lack thereof must be documented, and eligibility is determined using the poverty level in effect at the time the service is received. Income and family size are generally the only factors taken into account. Assets and expense levels are not generally taken into consideration.
B) Valley Health will use the Virginia Indigent Health Care Trust Fund (VIHCTF) Guide to define the eligibility requirements for this portion of charity assistance. (see also Policy PAFA3)
C) If a patient does not meet the eligibility guidelines according to the VIHCTF guide, then the financial counselor will review the documentation to determine if the patient meets another form of assistance or if other arrangements need to be made to meet this financial obligation.
Patients with Gross Annual Family Income Between 100% and 200% of Guidelines
A) Patients whose gross annual family income is between 100% and 200% of the federal non-farm poverty levels as published in the then current year Federal Register are eligible and encouraged to apply for Valley Health charity assistance. Income or lack thereof must be documented, and eligibility is determined using the poverty level in effect at the time the review is done. Income and family size are generally the only factors taken into account. Assets and expense levels are not generally taken into consideration.
B) If a patient does not meet the eligibility guidelines according to the federal poverty guidelines, then the financial counselor will review the documentation to determine if the patient meets another form of assistance or if other arrangements need to be made to meet this financial obligation.
Patients with Gross Annual Family Income Between 200% - 300% of Guidelines
If the applicant’s family income is between 200% - 300% of the federal poverty guideline, the application will be reviewed for the below potential sliding scale assistance. This assistance is contingent on a payment plan agreed to according to Valley Health payment plan guidelines. Nonpayment of the amount due could result in the assistance being reversed and the patient being expected to pay the original amount. Normal collection procedure will be initiated for the full amount.
$0 - $500
$500 - $5,000
$5000 - $25,000
$25,000 - $100,000
Greater than $100,000
Valley Health will consider financial assistance for hardship cases that involve, but are limited to, extraordinary medical bills, extended unemployment that does not result in satisfying other income criteria, or projected, continued chronic medical care. Such cases must be approved by the entity’s Chief Financial Officer or designee.
STANDARDS FOR INCOME CALCULATION DEFINITION
1. Income is defined as total gross wages of the applicant and those of her/his legally responsible relatives with whom she/he resides. The total countable income for this purpose includes all gross earned and unearned income.
2. Income includes taxable employer wages, self-employment income, Social Security benefits (SSA), Title II (Social Security Disability Insurance), Railroad Retirement benefits, Veterans’ benefits and any other predictable income, including alimony, child support, unemployment compensation, workers compensation benefits and donations of income.
3. Support from a spouse or parent (natural, adoptive or stepparent) living in the home is assumed to be available to the applicant, especially as it pertains to the number of persons claimed as a dependent on the income for subsistence (and included in the number of dependent calculation).
4. Support from a spouse or parent living in the home is assumed to be available to the spouse or dependent children under 21 who are living in the home.
EXAMPLES OF INCOME NOT INCLUDED IN DETERMINING ELIGIBILITY
1. Any portion of SSI payments or Auxiliary Grant programs
2. Value of food stamps under a state or local Food Stamp Program
3. Benefits received under Title VII, Nutritional Program for the Elderly
4. Any grant or loan to any undergraduate student for educational purposes, including Pell grants and PLUS Loans
5. Foster Care payments
6. Supplemental Food Assistance, covered by school meal programs and the WIC program.
7. HUD Assistance under Section 8 or Section 23.
The above lists are not all inclusive and are meant to serve only as guidelines and/or examples.
2013 Valley Health
P.O. Box 3340, Winchester, VA 22604
Phone: (540) 536-8000