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							<td valign="top" class="ChildNav1" style="" id="cLink223_6"><a href="body.cfm?id=225" target="" class="clSubb1">Surgery Guide</a></td>
						
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							<td valign="top" class="ChildNav1" style="" id="cLink223_9"><a href="body.cfm?id=555803" target="" class="clSubb1">Spiritual Support</a></td>
						
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							<td valign="top" class="ChildNav1" style="" id="cLink223_10"><a href="body.cfm?id=716" target="" class="clSubb1">Patient Rights</a></td>
						
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							<td valign="top" class="ChildNav1" style="" id="cLink223_11"><a href="body.cfm?id=558583" target="" class="clSubb1">Stay Connected with CarePages</a></td>
						
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						<tr id="cRow223_12" style="vertical-align: top; background-color: transparent;" >
						
							<td valign="top" class="ChildNav1" style="" id="cLink223_12"><a href="body.cfm?id=555921" target="" class="clSubb1">Patient Financial Information</a></td>
						
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						<tr id="cRow223_13" style="vertical-align: top; background-color: transparent;" >
						
							<td valign="top" class="ChildNav1" style="" id="cLink223_13"><a href="body.cfm?id=717" target="" class="clSubb1">Patient Responsibilities</a></td>
						
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							<tr>
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						<tr id="cRow223_14" style="vertical-align: top; background-color: transparent;" >
						
							<td valign="top" class="ChildNav1" style="" id="cLink223_14"><a href="body.cfm?id=558617" target="" class="clSubb1">Health Risk Assessment</a></td>
						
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		<H1>Financial Assistance Policy</H1>
		
		
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<p><strong>Espanol <br /></strong><a target="_blank" href="/documents/GSH_Patient_Information_Sheet_Sp_31011.pdf" title="Spanish Financial Assistance Policy Patient Information">Hoja Informativa <br />Para El Paciente</a></p>
<p><a target="_blank" href="documents/GSH-FA-APP-SP.pdf">Solicitud de<br />Asistencia Financiera</a></p>
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<p>MedStar Good Samaritan&nbsp;Hospital is committed to ensuring that uninsured patients within its service area who lack financial resources have access to medically necessary hospital services. If you are unable to pay for medical care, have no other insurance options or sources of payment including Medical Assistance, litigation or third-party liability, you may qualify for <strong>Free or Reduced Cost Medically Necessary Care</strong>.<br /><br />MedStar Good Samaritan&nbsp;Hospital&nbsp;meets or exceeds the legal requirements by providing financial assistance to those individuals in households below 200% of the federal poverty level and reduced cost-care up to 400% of the federal poverty level.</p>
<h4>Patients' Rights</h4>
<p>MedStar Good Samaritan&nbsp;Hospital will work with their uninsured patients to gain an understanding of each patient's financial resources.&nbsp;</p>
<ul>
<li>They will provide assistance with enrollment in publicly-funded entitlement programs [e.g. Medicaid] or other considerations of funding that may be available from other charitable organizations.</li>
<li>If you do not qualify for Medical Assistance, or financial assistance, you may be eligible for an extended payment plan for your hospital medical bills.</li>
<li>If you believe you have been wrongfully referred to a collection agency, you have the right to contact the hospital to request assistance. [See contact information below]. </li>
</ul>
<h4>Patients' Obligations</h4>
<p>MedStar Good Samaritan&nbsp;Hospital believes that its patients have personal responsibilities related to the financial aspects of their healthcare needs. Our patients are expected to:</p>
<ul>
<li>Cooperate at all times by providing complete and accurate insurance and financial information.</li>
<li>Provide requested data to complete Medicaid applications in a timely manner.&nbsp;</li>
<li>Maintain compliance with established payment plan terms.</li>
<li>Notify us timely at the number listed below of any changes in circumstances. </li>
</ul>
<h4>Contacts</h4>
<p>Call 410.933.2424 or 1.800.280.9006 [toll free]&nbsp;with questions concerning:</p>
<ul>
<li>Your hospital bill</li>
<li>Your rights and obligations with regards to your hospital bill</li>
<li>How to apply for Maryland Medicaid</li>
<li>How to apply for free or reduced care </li>
</ul>
<h4>For information about Maryland Medical Assistance</h4>
<p>Contact your local Department of Social Services at 1.800.332.6347. For TTY, call 1.800.925.4434.</p>
<p>Learn more about Medical Assistance on the Maryland Department of Human Resources website: <a target="_blank" href="http://www.dhr.maryland.gov/fiaprograms/medical.php">www.dhr.maryland.gov/fiaprograms/medical.php</a></p>
<h4>Physician charges are not included in hospitals bills and are billed separately.</h4>
<p>&nbsp;</p>
<h3>Financial Assistance Application</h3>
<p><a target="_blank" href="documents/Uniform-Financial-Assistance-Application-GSH.pdf" title="Uniform Financial Assistance Application Good Samaritan Hopsital" class="pdf">Click here</a> to&nbsp;download the Maryland State Uniform Financial Assistance Application&nbsp;</p>
<p dir="ltr"><a target="_blank" href="http://www.adobe.com/products/acrobat/readstep2.html" class="pdffootnote" style="font-size: 12px;">Download Adobe Reader</a></p>
		
	






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									<a href="http://www.medstarhealth.org/" target="_blank">MedStar Health Facilities</a> | <a href="body.cfm?id=150">Disclaimer</a> | <a href="http://www.medstarhealth.org/body.cfm?id=385" target="_blank">Privacy Policy</a> | <a href="body.cfm?id=555948">Site Map</a>	<br>
									MedStar Good Samaritan Hospital of Maryland | 5601 Loch Raven Boulevard | Baltimore, MD 21239 | 443.444.8000 | Copyright 2013<br><a title="Find us on Facebook" href="http://www.facebook.com/medstargoodsam" target="_blank"><img src="images/facebook-small.png" border="0" /></a> <a title="Follow us on Twitter" href="http://twitter.com/medstargoodsam" target="_blank"><img src="images/twitter-small.png" border="0" /></a> <a title="Watch Videos on YouTube" href="http://www.youtube.com/medstarhealth" target="_blank"><img src="images/youtube-small.png" border="0" /></a> <a href="body.cfm?id=558583"><img src="images/carepages-small.png" border="0" /></a>								</td>
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		   return html;
		};
		//grab a youtube id from a (clean, no querystring) url (thanks to http://jquery-howto.blogspot.com/2009/05/jyoutube-jquery-youtube-thumbnail.html)
		function youtubeid(url) {
			var ytid = url.match("[\\?&]v=([^&#]*)");
			ytid = ytid[1];
			return ytid;
		};
		//load inital video
		var firstVid = selector.children("li:first-child").addClass("currentvideo").children("a").attr("href");
		$("#"+options.holderId+"").html(play(youtubeid(firstVid)));
		//load video on request
		selector.children("li").children("a").click(function() {
			if(options.showInline) {
				$("li.currentvideo").removeClass("currentvideo");
				$(this).parent("li").addClass("currentvideo").html(play(youtubeid($(this).attr("href"))));
			}
			else {
				$("#"+options.holderId+"").html(play(youtubeid($(this).attr("href"))));
				$(this).parent().parent("ul").find("li.currentvideo").removeClass("currentvideo");
				$(this).parent("li").addClass("currentvideo");
			}
			return false;
		});
		//do we want thumns with that?
		if(options.addThumbs) {
			selector.children().each(function(i){
				var replacedText = $(this).text();
				if(options.thumbSize == 'small') {
					var thumbUrl = "http://img.youtube.com/vi/"+youtubeid($(this).children("a").attr("href"))+"/2.jpg";
				}
				else {
					var thumbUrl = "http://img.youtube.com/vi/"+youtubeid($(this).children("a").attr("href"))+"/0.jpg";
				}
				$(this).children("a").empty().html("<img src='"+thumbUrl+"' alt='"+replacedText+"' />"+replacedText).attr("title", replacedText);
			});	
		}
  });
};</script>
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