Financial Assistance

The Financial Assistance Policy (“FAP”) of Rothman Orthopaedic Specialty Hospital, L.L.C. (“ROSH”) exists to provide financial assistance to patients who have healthcare needs and are uninsured, underinsured, ineligible for other government assistance, or are otherwise unable to pay for emergency or other medically necessary healthcare services based on their individual financial situation. Patients seeking financial assistance must apply for the program, which is summarized herein.

Eligible Services

Financial assistance is only available for emergency or other medically necessary healthcare services. Not all services provided within ROSH are covered under the FAP. Certain services which are separately billed by other providers may not be covered. Please refer to Appendix A of ROSH’s FAP for a list of providers that provide healthcare services within the hospital facility and whether or not they are covered under the FAP.

Eligible Patients

Patients receiving eligible services, who satisfy the eligibility criteria and submit a completed financial assistance application including all required documentation.

How to Apply

The FAP and FAP Application may be obtained / completed / submitted as follows:

Download the documents from the following website: http://rothmanorthohospital.com/for-patients/financial-assistance/
Request documents be mailed to you, by calling the Billing Office at (215) 244-7481.
Paper copies are available, free of charge, at the Registration Desk of Rothman Orthopaedic Specialty Hospital located at 3300 Tillman Drive, Bensalem, PA 19020.
Patients may schedule an appointment with a Business Office associate for assistance in completing an Application. If a patient chooses to complete an Application individually, they should mail the completed Application (with all required supporting documentation) to: Rothman Orthopaedic Specialty Hospital, Attn: Billing Office, 3300 Tillman Drive, Bensalem, PA19020.

Financial Assistance Eligibility

Generally, uninsured and underinsured patients may be eligible for full financial assistance when their family gross income is less than 200% of the Federal Poverty Guidelines (“FPG”).

Note: Other criteria beyond FPG may also be considered (i.e. previous denials of public assistance and insurance status), which may result in exceptions to the preceding. ROSH’S Business Office will review submitted applications, and determine financial assistance eligibility in accordance with the FAP.

Any individual determined to be eligible for financial assistance under the FAP will not be charged more than Amounts Generally Billed (“AGB”) for emergency or other medically necessary healthcare services. Any FAP-eligible individual will always be charged the lesser of AGB or any discount available under the FAP.

Availability of Translations

The FAP, Application and PLS are available in English and in the primary language of populations with limited proficiency in English (“LEP”) that constitutes the lesser of 1,000 individuals or 5% of the community served by ROSH.

For help, assistance or questions please call the Billing Office at (215) 244-7481.

Financial Assistance Policy
Application Form