Columbus Regional Health is committed to providing health care services regardless of a patient’s ability to pay. Patients who express an inability to pay and who meet the policy’s financial criteria will be covered under the Financial Assistance Policy.
Information concerning the Financial Assistance Policy at Columbus Regional Hospital can be found on the back of each patient statement, on this web site, in the Billing and Financial Assistance Guide found in multiple patient waiting areas around the hospital, by calling Patient Financial Services customer service representatives as 812-376-5315 or 1-800-841-4954 (Hours 8:00am to 4:30 pm, Monday through Friday). This policy is available in both English and Spanish.
Please make sure that you return the following with your completed your financial assistance application:
Proof of Household Income — a copy of most recently filed Income tax return (1040 form) and a copy of most current pay check stub.
- If self-employed a copy of the self-employment tax return is also needed.
- If you did not file taxes last year but received a monthly benefit from Social Security, Disability or Unemployment; a copy of the award letter showing the monthly payment amount is needed.
- If you do not have an award letter, a copy of the bank statement showing the deposited amount is acceptable.
Failure to return the needed information may result in your request being denied.
Please feel free to contact us at 812-376-5315 or toll free 1-800-841-4954 if you have any questions or concerns.
Amounts Generally Billed (AGB) Calculation Summary
Per Treasury Regulations §1.501(r)-5(a)(1), a hospital must limit the amount charged for care provided to any individual who is eligible for assistance under its financial assistance policy to not more than amounts generally billed (AGB) in the case of emergency and other medically necessary care. Columbus Regional Hospital calculates an AGB percentage based on the look-back method and is based on actual claims paid. In accordance with §1.501(r)-5(b)(3)(i), AGB percentage is based on the Medicare fee-for-service and all private health insurers that pay claims to the hospital facility.
The AGB is calculated annually by dividing the sum of the amounts of all of its claims for emergency and other medically necessary care that have been allowed by Medicare and Commercial insurers during a prior 12-month period by the sum of the associated gross charges for those claims. For 2020, the 12-month period utilized was September 1, 2019 – August 31, 2020. The resulting calculation for AGB was 40% and is effective January 1, 2021 for Columbus Regional Hospital.