Financial Assistance Program

Financial Assistance Program

Cape Fear Valley Medical Center’s Financial Assistance program provides financial assistance for qualifying patients who need help paying for emergency or medically necessary care they receive at Cape Fear Valley, Highsmith Specialty Hospital, Bladen Healthcare, Hoke Healthcare and all CFV owned clinics.

  • Charity (indigent) – household income that is equal or less than 200% of the Federal Poverty Guidelines. Qualifying applicants will be responsible for a co-pay, then will receive 100% assistance with their hospital obligation.
  • Uninsured – patients with no health insurance. All uninsured patients will receive a minimum of 30% discount.
  • Medically Indigent – patients who:
    • Have health coverage, but it does not provide full coverage for all their medical expenses, and
    • These medical expenses, in relation to their income, would make them indigent if they were forced to pay full charges.
  • Limited Means – Income between 250% and 500% of the Federal Poverty Guidelines. Qualifying applicants will receive partial assistance. Those who have limited means will receive care at a discount. Discounts are on a sliding scale and range from 45% to 85%.
  • Interest-Free Payment Arrangements – allows a patient up to six months to pay an outstanding balance without accruing interest

Patients must fill out an application to apply and must meet the eligibility requirements listed below to qualify.

Who is eligible for Financial Assistance and what are the requirements?

The program helps low-income, uninsured, or underinsured patients who need help paying for all or part of their medical care. Patients are eligible for Financial Assistance when their Family Income is at or below 200% of the Federal Poverty Guidelines https://aspe.hhs.gov/poverty-guidelines.com. Other documentation as mentioned below and in our FAP policy may be required to determine eligibility. Any patient who meets the criteria may be eligible for financial assistance.

  • Income from all sources
  • Copies of statements from savings and checking accounts, certificates of deposit, stocks, bonds, money market accounts, etc.
  • Value of assets including home and real estate
  • Monthly expenses
  • Number of dependents
  • Copies of most recent pay stubs (three months)
  • Copies of most recent state and federal income tax forms, including documentation (see policy)

Patients who are eligible for medical financial assistance will not be charged more than amounts generally billed (AGB) for emergency or other medically necessary care to patients with insurance (AGB, as defined by IRS Section 501(r)).

What does the program cover?

Financial Assistance covers Cape Fear Valley, Highsmith Specialty Hospital, Bladen Healthcare, Hoke Healthcare and all CFV owned clinics Not all costs are covered; hearing aids, cosmetic surgery, non-urgent or elective care and/or optical.

How do I Apply?

You can get an application from any of the following sources:

  • Any of our hospitals or clinic registration desks
  • Customer Service located at the PFS (Patient Financial Services) building at 227 Fountainhead Lane, Fayetteville, NC.
  • Call 8a.m. to 5p.m. Monday through Friday (910) 615-7070.
  • By mail (at no cost); just call and request it to be sent to you
  • Download and print the application by clicking the link provided below

Please mail completed applications (with all required documentation and information specified in the application instructions) to PO Box 2000, Fayetteville, NC 28302, Attention Financial Assistance Specialist, or by giving it to the person at the Hospital or Clinic registration desk.

Your application, with required documentation is then reviewed. If there is something missing, we will notify you and provide you a chance to provide it, so the application can be considered.

Is there language assistance?

Interpreters are available to you at no cost. The CFVMC Financial Assistance application, policy, and this policy summary may be available in your language. For more information, call (910) 615-7070. For TTY, call (910) 615-5864.

How can I get a copy of CFVMC’s Financial Assistance Policy?

You can also ask for a free copy of Cape Fear Valley Medical Center’s Financial Assistance policy by calling (910) 615-7070 or by picking one up at 227 Fountainhead Lane, Fayetteville, NC.

For help or questions about the Financial Assistance application process, please call (910) 615-7070, or inquire at our registration desks in the hospital or clinics.

For full information on the Financial Assistance Program, please see the Financial Assistance Program Guidelines Policy below.

Financial Assistance Policy
Financial Assistance Application