Financial Assistance Program Summary

The Financial Assistance Program (FAP) is for Delta County Memorial Hospital (DCMH) Facility Billing and is separate from our Physician Billing sliding scale. The Guarantor (the person responsible for the bill) can apply and become eligible for Financial Assistance through our Charity Care Program to discount your patient balance on bills that are emergent or medically necessary services unless you are covered by Health First Colorado Medicaid or CHP+, then assistance would not be needed.

Eligibility Criteria - Basis for Calculating Amounts - How to Apply
Please contact our Financial Counselor at 970-874-2226 for any assistance with your bills. You may also call 970-874-7681 or email the Business Office for billing questions. You can access the Charity Care Application here, you can request a copy be mailed to you, or you can pick up a copy with our Financial Counselor or Cashier at 1501 E 3rd Street Delta, CO 81416 or at the Business Office 100 Stafford Lane, Delta, CO 81416. There is no charge for copies given or mailed.

All Guarantors, whether insured or uninsured, become eligible for a discount under FAP by completing the Charity Care Application and providing the requested documentation and signatures. Please contact us if you need information mailed to you by calling 874-2226. The yearly income scale below is showing the discounted amount based on your yearly income.

FAP Charity Care Discount Scale:

Yearly Income
0 - $30,0000.00
$31,000.00 - $50,000.00
$51,000.00 - $70,000.00
$71,000.00+
Discount
25%
20%
15%
10%

Once you are approved, you will be set up on the payment plan of your choice. After three payments are received, the discount will be applied to the original patient balance and after any insurance payments and contractual adjustments, if applicable. This amount is based on pricing that comes from our charge master that is changed on January 1 of each year.

Payment plan options to choose from include: 6, 12, or 24-month increments or using AR Services (ARS), a company in Grand Junction, CO that we are a part owner. No interest is added. ARS assists with collecting but is not a credit reporting agency. You can also pay your bill on our website under Patient Info.

If you do not complete the application, sign, and attach the required documentation, you will be notified that your application was not approved.

Non Payments Made Without Extraordinary Collection Activities (ECA)

DCMH or ARS will attempt to collect balances due by sending statements and/or calling directly to the Guarantor. If no payments are made or monthly payment contracts are not set-up, your balance will be sent to A1 Collection Agency (A1) after a 130-day review and your discount will be reversed. If you did not apply for Charity Care and your account balance was sent to A1, you will still be eligible to apply for Charity Care to a minimum of 240 days. If approved at this time, we will remove the balance from A1 and return it to DCMH and you will be set-up on a payment plan of your choice. Interest will only be added when A1, a credit reporting agency, is collecting your balance.

Colorado Indigent Care Program (CICP)

DCMH offers Colorado Indigent Care Program (CICP) for emergency services only and you qualify based on your family annual income. You will need to fill out a CICP Application and contact our Financial Counselor at 970-874-2226 for any assistance. The CICP program must be applied for within 90 days of your date of service.

Complete FAP Charity Care Policy


FAP Charity Care Application


CICP Application