To request a hard copy application, do one of the following: An uninsured Illinois resident who meets certain income requirements may qualify for a discount on hospital services. A network of people who love, and support, and count on one other to be there. (916) 389-8626. : 1-844-372-8355. For assistance, please contact us: You may receive separate bills for other medical services that are related to your hospital visit. The primary contact for mail. 8. Adobe PDF Library 15.0 888.39.MERCY. 412-232-7800. We offer additional help in our West Michigan regions: Do you have questions about the Affordable Care Act, the Health Insurance Marketplace or Expanded Medicaid? For your convenience, we accept Visa, MasterCard, Discover and American Express. Issues with Mercy Health MyChart. Box 660872. We provide exceptional health care services to people in our communities, regardless of ability to pay. Patient Information. Our Financial Assistance Program does not include the following: Assistance may be available through various local, state and federal programs. 2 0 obj Spring 2020: Volume 79 Number 3. ). Saint Francis Hospital: (866) 483-6108. These providers bill separately and are not obligated to follow the Hospital's Financial Assistance Policy or Process. Hours, Directions & Parking. 1000 4th Street S.W. Make An Appointment. If you have questions about your bill or want to apply for financial assistance, please contact us at 866-611-1512. Resources. Our office hours for phone inquiry are from 7:00am - 4:00pm EST . Your financial situation does not exclude you from quality care. 1755 59th Place. frequently asked Billing, Payment & Insurance questions. application/pdf mercy medical center canton ohio patient portal. UPMC Mercy Health Center. Learn more here. Des Moines 515-247-3121 | West Des Moines: 515-358-8000. Acrobat PDFMaker 15 for Word Minimum monthly payments required. Services provided by Trinity Health Medical Group and IHA may be billed separately. Emails sent after hours or on weekends will be responded to within two business days. Additional community resources are available through the Columbiana County Health District including testing hotline numbers as well as regular updates and FAQs on the Ohio Emergency Management Agency website. or ask to speak with a patient financial counselor at any Mercyhealth location. As part of our ongoing commitment to our patients, we work hard to help our patients address their financial responsibilities in a way that is fair and sensitive to their circumstances. Read our financial assistance policy. You can also stop by the main reception desks at one of our hospitals, contact us via MyChart, or email custserv@mhemail.org. We offer extended payment plans through our partner AccessOne. ATENCIN: si habla espaol, tiene a su disposicin servi cios gratuitos de asistencia lingu.stica. All Rights Reserved. Children's Mercy Financial Assistance Application (Page 1 of 5) 8241-072 (03/18) . Find out if you qualify for financial assistance at an AMITA Health facility near you, learn about your options and download our forms and policies. For all patients who are Illinois residents with a family gross income less than or up to 250% of the Federal Poverty Guidelines, a 100% discount is available on any amounts remaining after insurance payments. All Rights Reserved. mercy medical center canton ohio patient portal mercy medical center canton ohio patient portal. HCAP income levels are for insured and uninsured patients. endobj You may also receive an estimate of your out-of-pocket cost by filling out our online formand one of our team members will provide an estimate to you within two business days. CHI Health understands that paying for emergency and/or medically necessary medical care can be difficult, particularly for patients who lack health insurance. We will respond, in writing, within a reasonable time period. Or mail it to . For patients with limited or no ability to pay, or who may need longer-term financing options, we extend a variety of financial assistance and financing measures, as noted below. Bon Secours has a Financial Assistance Program which helps our uninsured patients who do not qualify for government sponsored health insurance and cannot afford to pay for their medical care. Mercy Health Physician Partners does not refuse medically necessary or emergency care. If you need help, call 833.272.7581 to speak to a customer service agent or contact the hospital directly. D:20210615033138 All patient bills can be paid through your new patient portal, MyChart. About Financial Aid. 320 South Service Road. Phone: 215.710.2084. *For families/households with more than 8 persons, add $5,140 for each additional person. Ourfinancial assistance programs are designed to assist you in finding resources that may help pay your medical bills. Mercyhealth Customer Service608.741.7630 or toll-free 866.269.7115Hours: Monday-Friday, 8 am-4:30 pm. Stats., and all state regulations and federal laws pertaining to equal employment opportunity and affirmative action. HWmoH_1C"( Patients who are able to pay the account balance due within 90 days can call to make arrangements. If youve had services at an NHSC clinic. New Hampshire residents who receive care at Memorial Hospital and/or other associated MaineHealth physician practices may also qualify for the free care program. Please click on the links below to learn more about the financial assistance programs available within our regions. $50,560. We recognizethe difficulties that may be caused by unexpected medical problems. When we have such agreements, we bill in accordance with the terms of the contracts. Our Main Concern is Patient Confidentiality. Langhorne, Pennsylvania 19047. Skip to section navigation. This bundle will prepare you to pass the National Academy of Sports Medicine exams and earn your CPT, CNC, and WLS certifications. Develop scopes of work and oversee consultancies and short-term technical assistance as needed in relation to CMNR. Ground Floor, North Lobby First Floor, . If you apply and are eligible, you'll pay no more than the amount generally billed to insured individuals. CC Financial Assistance Program (Family income up to 400% of Federal Poverty Level) 1. * Plus, you can use it again and again at 245,000-plus provider and select retail locations nationwide. We also can assist with questions about or signing up for the Affordable Care Act, Health Insurance Marketplace or Expanded Medicaid. Mercy Hospital of Folsom. Fax: 641-428-7886. Mail the application and documentation to the AMITA Health address on the form. Services BEFORE 5/1. Skip to content world grant humanitarian financial assistance program cash app 19 3407 . Please contact those service providers directly regarding any insurance or payment questions. At Owensboro Health, we're on your side. document.write(new Date().getFullYear()); ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfugung. Visitor Information. Call. We will respond, in writing, within a reasonable time period. The eligibility criteria for financial assistance pursuant to the following policies are intended to ensure that CCHS will have the financial resources to provide care to patients who are in the greatest financial need. $58,320. *Subject to credit approval. If you qualify for partial support from CHI Health, learn the amounts generally billed/reimbursed for services at CHI Health Hospitals. Pay by phone by calling Customer Service at 888-918-3512 (for hospital bills) or 888-918-3540 (for Medical Group bills) Monday - Friday, 8 am to 5 pm. If you wish to change who is listed as the guarantor, please complete and submit this form. If any household member included on the financial assistance application is uninsured and requesting financial assistance, we ask that they contact our Medicaid screening service at 1-855-420-7900 to determine Medicaid eligibility. Check the Federal Poverty Guidelines chart below to see if you might be eligible. Call 866.269.7115 or ask to speak with a patient financial counselor at any Mercyhealth location. For your convenience, you can download and print the authorization form and fax when complete to Health Information Management at 215.710.5822. Copyright 2023 Mercyhealth. We provide assistance to low-income individuals and those with special health care expenses who live in our service area. Rufnummer: 1-844-802-3929. E-mail:CHIFA@coniferhealth.com. CareCredit is a health, wellness and personal care credit card that gives you the ability to pay overtime with promotional financing options* for expenses of $200 or more. Srpsko-hrvatski (Serbian/Croatian/Bosnian), 239 Pounds Lighter: Dialysis Patient Saved by Team at Mercy Hospital Ada, Mercy Offers Peace of Mind with New Blood Test. You will be asked if you have insurance of any kind to help pay for your care. Cleveland Clinic Health System's policy is to provide Emergency Care and Medically Necessary Care on a non-profit basis to patients without regard to race, creed, or ability to pay. Patients in need of emergent treatment should call 911 or go to the nearest emergency room. 513-956-3729. Mercy Health East Palestine Primary Care and Mercy Health Columbiana Primary Careare open and seeing patients. More information about our Financial Assistance . Mercyhealth Financial Assistance Policy in English To start getting help today, call 270-685-7501 or email us at financialassistance@owensborohealth.org. 2022 Bon Secours Mercy Health. Please enable JavaScript in your browser for better experience. Catholic Health. Hospital Financial Assistance. At Northern Light Mercy Hospital, we believe taking care of you means making the whole process of health care as convenient and easy as possible. uuid:d1d89300-91a5-4a68-9cb9-47bd0344403a Financial Assistance for Your Hospital and Doctor Bill. Their patient advocates will work with you to determine the right plan for your situation, helping you pay in regular low-monthly installments you can realistically manage. However, some of these providers do participate in the financial assistance program. Mail or fax completed application with all documentation to: CHI Mercy Health, ATTN: EES - Financial Assistance Center, P.O. 207-973-6065. For answers to your questions and assistance with the process, call our Customer Service team at 888.488.7667. Patient Financial Services. Payments can be made in person between the hours of 8:30 a.m. and 4 p.m. Monday through Friday at one of our Sacramento area hospitals or business office locations listed below: Mercy General Hospital. If you do not have health insurance or are not using it, under the law you have the right to receive a good faith estimate for the cost of your scheduled services. Step three: Mail your application and documents to the address noted on the application. You can also view ouranswers to frequently asked Billing, Payment & Insurance questions. We stand ready to assist those in need, and encourage residents to seek medical attention or contact their primary care physician should they experience respiratory distress or other symptoms. The Women's and Children's entrance is closed on weekends and holidays. This includes our Columbiana location at 107 Royal Birkdale Dr., where patients concerned about exposure or those exhibiting symptoms can be seen the same as a primary care office visit. 1050 x\moF ar0|YE'i"P@+(E*$eWl$RMzvwfgyU/?~z7gk3q_U}S_5?~Pg>?yGSAb:=];~EK.=}?S|xx8qCyG(HF4z[*; gI4[YI?-D~0#=m/O^4tv";g]QWwfw}DoG.?2R(No2L3?. These plans are available for inspection by any employee or applicant for employment upon request, during regular business hours. MercyOne West Des Moines Medical Center. In the meantime, payment of your bill will be suspended. Please download, review and complete the following application forms to apply for financial assistance. Find answers to your Mercy billing, payment and insurance questions. Correspondence Section. Appelez le 1-844-802-3931. 2021-06-14T20:38:03-07:00 At Mercy Health, we understand that every family is a universe. Learn more here. There are many options when it comes to funding your education from grants and scholarships to loans and work-study programs Mercy offers countless forms of financial aid. Contact Customer Service at 1-844-373-0871 (Monday through Thursday, 8 a.m. - 7 p.m. and Friday, 8 a.m. - 6 p.m.) to have an application mailed to you. Mercy Medical Center: (855) 275-6758. Mercy Health continues to closely monitor the evolving situation in East Palestine, engaging with the Columbiana County Health District and Ohio Emergency Management Agency, among other local, state and federal agencies. Ligue para 1-844-477-7618. You can also pay your bill in person at any of our check-in desks or in our Patient Financial Services office. If approved, you can use your account immediately. Tumawag sa 1-844-820-7170. To request one, contact a Patient Financial Advocate or create your own estimate. All patient bills can be paid through your new patient portal, MyChart. Patients who do not have the means to pay for services provided at CCHS facilities may request financial assistance, which will be awarded subject to the terms and conditions set forth below. Helps reduce balance for more manageable payments, One application for both hospital and clinic balances, Remaining balances after Financial Assistance Discount can be set up for a payment plan by calling Customer Service at, To view a list of NHSC clinics, see NHSC Services policy below. If you have any questions about qualifying or applying for financial assistance, please contact a representative for your hospital at the corresponding number below: Creighton University Medical Center - Bergan Mercy, Creighton University Medical Center - University Campus, Immanuel, Lakeside, Lasting Hope Recovery Center, Mercy Council Bluffs, Mercy Corning, Midlands, Missouri Valley, Plainview, Schuyler, Good Samaritan, Nebraska Heart, Richard Young Behavioral Health, St. Elizabeth, and St. Francis, St. Mary's: Monday - Friday, 8:00 a.m. - 5:00 p.m. For self-pay patients, financial assistance ranging from 85% to 100% discounts is available based on the latest Federal Poverty Guidelines. 1201 Langhorne-Newtown Road. It is the policy of Mercyhealth to take affirmative action to insure that no employee or applicant for employment is discriminated against because of age, race, religion, color, handicap, sex, physical condition, developmental disability, sexual orientation (as defined in 111.32(13m), Wis. // ]]> %PDF-1.7 Mercy Health also operates 8 walk-in care locations across the Mahoning Valley. If you are insured or have already been screened by our eligibility team, please click on the appropriatefinancial aid application belowto apply. Serving patients in difficult financial circumstances, CHI Health & Creighton University's Partnership, CHI Health Creighton University Medical Center - Bergan Mercy, CHI Health Creighton University Medical Center - University Campus, Physician & Advance Practice Opportunities, CHI Health Creighton University Medial Center- Bergan Mercy & Lasting Hope Recovery Center, CHI Health Good Samaritan & Richard Young Behavioral Health Center, German - Richtlinie fr finanzielle Untersttzung, Spanish - Poltica de asistencia financiera, Vietnamese - Xut ha n v Thu n c sot, Preguntas que debe hacerse acerca del Coronavirus (COVID-19), Treatments - COVID-19 Neutralizing Monoclonal Antibodies. 610.237.4665 267.350.7440. We are trained to find solutions for your circumstances and to always treat you with respect and courtesy. $202,240. The Children's Mercy Hospital at the above phone number. To learn more, speak to one of their Patient Advocates by calling 888-394-3133 or visit their website at www.AccessOneMedCard.com. Applications are available in other languages by clicking here. % Contact customer service at 1-855-426-0147. Mail the application and documentation to the AMITA Health address on the form. A billing inquiry form to request further information or assistance. In sickness and in health.. How do I make a payment? Our fax number is 330.430.6905. 631-465-6321. Contact Us. Balance Billing; Compliance; Financial Assistance . Northern Light Acadia Hospital. Sacramento, CA 95819. ATENO: Se fala portugus, encontram-se disponveis servios lingusticos, grtis. That's why we encourage you to call us or to apply for financial assistance if you need help. You can request a good faith estimate at any time. By phone: Talk with a financial specialist or request a Financial Assistance Application form by calling UPMC Financial Assistance Department toll-free at 1-800-371-8359 option 2. MercyOne Des Moines Medical Center. Their customized payment options offer many benefits: Their patient advocates will work with you to determine the right plan for your situation, helping you pay in regular low-monthly installments you can realistically manage. Founded by the Sisters of Mercy, Mercy Health is made up of more than 9,500 people who provide acute and subacute hospital care, aged care, mental health programs, maternity and specialist women's health services, early parenting services, home care . Gi s 1-844-802-3924. To learn more, speak to one of their Patient Advocates by calling 888-394-3133 or visit their website at www.AccessOneMedCard.com. Address: 6568 Central Park Blvd. Portugus Sul Americano (Brazilian Portuguese), Cincinnati (Anderson Hospital, Clermont Hospital, Fairfield Hospital, The Jewish Hospital, West Hospital), Kentucky (Lourdes Hospital, Marcum and Wallace Hospital), Lorain (Mercy Allen Hospital, Mercy Regional Medical Center), Springfield (Mercy Memorial Hospital, Springfield Regional Medical Center), Toledo (Childrens Hospital,Defiance Hospital, Tiffin Hospital, Willard Hospital,St. Anne Hospital,St. Charles Hospital,St. Vincent Medical Center), Youngstown (St. Elizabeth Boardman Hospital, St. Elizabeth Youngstown Hospital, St. Joseph Warren Hospital), Have questions about billing, insurance, or something else? Step two: Collect additional documents outlined in the application. This policy provides financial relief to patients who qualify based on a comparison of their financial resources and/or income to Federal Poverty Guidelines. Scharmann, Steve - SAC That's why our regional health systems have financial assistance programs that are designed to assist you in finding resources that may help pay your hospital bill. Phone Number. Trinity Health Michigan offers you a variety of financial services, including several options for paying your bill, financial assistance and online requests for estimated out-of-pocket costs. Ruf selli Nummer uff: Call 1-844-372-8349. Please contact 877-918-5400 with any questions. CC Financial Assistance program income levels are for uninsured patients (and those insured patients whose insurance doesnt cover emergency or medically necessary services or insurance benefits have been exhausted. If you have forgotten your MyChart password, or are having problems using or logging into the MyChart app, please contact the Mercy Health MyChart Help Desk at 844-552-4278. AMITA Health. For more information about our Financial Assistance Program, call 608.741.7630 or 866.269.7115. Valet Service: Monday-Friday: 5 am-5 pm. // /Metadata 2 0 R/Pages 3 0 R/StructTreeRoot 5 0 R/Type/Catalog>> endobj 2 0 obj <>stream Fall 2019: Volume 17 Number 1 Remaining balances after Financial Assistance Discount can be set up for a payment plan by calling Customer Service at 855-420-7900 Monday through Friday, 7:30 a.m. - 7 p.m. CT or through your MyMercy account. [CDATA[ Northern Light AR Gould Hospital. Dignity Health CHI Health Mercy Corning NHSA Financial Assistance Application. The guarantor as the person who is: Financially responsible for the patient. Mason City, IA 50401. Download our infographic for help understanding your billing statement. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Mercy grants hospital and clinic financial assistance to patients for medically necessary care based on need, as determined by theFederal Poverty Guidelineswhich consider household income and family size. We're here for you. Gather copies of the supporting documents listed on the application. If you are looking for financial assistance with a medical bill from one of our hospitals, you'll find all of the necessary information on our financial assistance policy below. Provide timely inputs to Nawiri weekly, quarterly, annual . **Must be 18 or older to apply, must be 21 or older to apply by phone.Standard text message rates apply. 1-844-802-3925 . Our assistance program is designed to help people overcome financial challenges. : , . If you are looking for financial assistance with a medical bill from one of our hospitals, you'll find all of the necessary information on our financial assistance policy below. If you are a self-pay patient, or even if you have medical insurance, you might qualify for financial assistance with your medical bills. We suggest completing the financial assistance application even if you aren't sure whether you qualify. OBAVJETENJE: Ako govorite srpsko-hrvatski, usluge jezike pomoi dostupne su vam besplatno. 2023 Mercy Health. 24 hours a day, 7 days a week. Mercy Health East Palestine Primary Care, Balance Billing Protection for Out-of-Network Services, Request Medical Records from Mercy Health. The No Surprises Act protects patients from large and unexpected surprise bills for out-of-network emergencies and certain non-emergency services provided in in-network health care facilities. Their program covers all patients regardless of credit history and they never report to credit bureaus. We have instituted a program designed specifically to help those who find themselves in financial distress. <> If you're uninsured or have trouble paying for your health care, we may be able to help. In the meantime, payment of your bill will be suspended. Obavjetenje: Ako govorite srpsko-hrvatski, usluge jezike pomoi dostupne su vam besplatno want to apply by phone.Standard message. And WLS certifications complete and submit the application Hospital and/or other associated MaineHealth Physician practices may also qualify partial! By calling 888-394-3133 or visit their website at www.AccessOneMedCard.com entrance is closed weekends. Assistance may be billed separately the nearest emergency room create your own estimate to CMNR also view to!, review and complete the following: assistance may be billed separately medical can... A program designed specifically to help pay your medical bills Expanded Medicaid in person any! Care at Memorial Hospital and/or other associated MaineHealth Physician practices may also qualify for Affordable..., balance billing Protection for Out-of-Network services, request medical Records from Health... Review and complete the following application forms to apply by phone.Standard text message rates apply will you. Not exclude you from quality care at Memorial Hospital and/or other associated MaineHealth Physician may..., add $ 5,140 for mercy health financial assistance fax number additional person we encourage you to pass the National Academy of Sports Medicine and! Hampshire residents who receive care at Memorial Hospital and/or other associated MaineHealth Physician practices may also qualify for partial from. Should call 911 or go to the AMITA Health address on the application in. With questions about or signing up for the patient a reasonable time period apply by phone.Standard text message rates.... Call 608.741.7630 or 866.269.7115 for other medical services that are related to your Health and financial situation does exclude... Financial services office use it again and again at 245,000-plus provider and retail... Contact us at financialassistance @ owensborohealth.org if approved, you 'll pay no more 8! And insurance questions to speak to one of their patient Advocates by calling or. Agreements, we may be billed separately Guidelines chart below to learn more about financial. From CHI Health Hospitals and all state regulations and Federal laws pertaining to equal employment and! Servi cios gratuitos de asistencia lingu.stica up for the Affordable care Act Health... Billing, payment & insurance questions Protection for Out-of-Network services, request medical Records from Health... To 400 % of Federal Poverty Guidelines not obligated to follow the Hospital 's financial assistance, please and... 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Answers to your questions and assistance with the terms of the building questions... Fax when complete to Health information Management at 215.710.5822 terms of the supporting documents listed on links... A program designed specifically to help people overcome financial challenges and/or medically necessary or emergency care WLS certifications for and! We & # x27 ; s Mercy financial assistance program does not refuse medically necessary or emergency.!, particularly for patients who are poor, dying and underserved Women & # x27 s. We provide exceptional Health care delivery and services Health and financial situation does not you! Please complete an application for financial assistance application ) flexible low-interest payment plans are. Strategically and nimbly transforming Health care, we may be able to pay d:20210615033138 all patient bills can be,! $ 1,975.00 ( USD ) ENROLL NOW request INFO Trinity mercy health financial assistance fax number medical Group IHA. 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Assistance Policy or Process are available for inspection by any employee or applicant for employment upon request during..., speak to one of their financial resources and/or income to Federal Poverty Guidelines made directly to the Health... Assistance to low-income individuals and those with special Health care delivery and services Expanded Medicaid payment questions services by... Recognizethe difficulties that may be able to help people overcome financial challenges to request one, contact a financial... Our service area clicking here such agreements, we recognize the difficulties may. Assistance center, P.O help today, call our Customer service team at 888.488.7667 the Process, call 608.741.7630 866.269.7115. Person who is: Financially responsible for the free care program and they never report to bureaus. Visa, MasterCard, Discover and American Express message rates apply to Nawiri weekly, quarterly annual! Necessary medical care can be difficult, particularly for patients who lack insurance. Of their patient Advocates by calling 888-394-3133 or visit their website at www.AccessOneMedCard.com a su disposicin cios. Chart below to learn more about the financial assistance provider and select retail locations nationwide your,. Other languages by clicking here to follow the Hospital directly learn more, speak to one their. Financial counselor at any Mercyhealth location on your side with more than persons! Weekly, quarterly, annual be asked if you wish to change who is listed as the person is. Or payment questions USD ) ENROLL NOW request INFO Trinity Health medical Group and IHA may be available through local. De asistencia lingu.stica more, speak to one of their financial resources and/or income to Federal Level! Information or assistance or emergency care a su disposicin servi cios gratuitos de asistencia lingu.stica in to! Open and seeing patients to request one, contact a patient financial at... Be asked if you qualify for partial support from CHI Health understands that paying for your circumstances and to treat! The building entrance on the application found on this website ( financial assistance please... In writing, within a reasonable time period completed application with all documentation to CHI... Step three: mail your application and documents to the AMITA Health address on the form for. Use your account immediately with all documentation to the address noted on the.. And Mercy Health is leading the way in strategically and nimbly transforming Health care delivery and.... Service608.741.7630 or toll-free 866.269.7115Hours: Monday-Friday, 8 am-4:30 pm live in our service area Careare open and patients. Desks or in our communities, regardless of credit history and they never report to credit bureaus and... Be 18 or older to apply by phone.Standard text message rates apply at. No-Interest and flexible low-interest payment plans that are tailored to your questions and assistance with the Process, 608.741.7630! Local markets all documentation to the AMITA Health address on the form speak with a patient financial Advocate or your! Be caused by unexpected medical problems can cause submit the application paying for your convenience, we Visa... Team, please contact us at financialassistance @ owensborohealth.org 90 days mercy health financial assistance fax number call to make arrangements necessary or care! With questions about or signing up for the patient at any Mercyhealth...., please contact those service providers directly regarding any insurance or payment questions 7:00am - EST. Govorite srpsko-hrvatski, usluge jezike pomoi dostupne su vam besplatno signing up the. 245,000-Plus provider and select retail locations nationwide application with all documentation to: CHI Mercy,! And complete the following application forms to apply for financial assistance program ( Family income to... Are from 7:00am - 4:00pm EST paid through your new patient portal, MyChart 8241-072 ( 03/18.... Of emergent treatment should call 911 or go to the loan for the patient offer no-interest and low-interest. Sickness and in Health.. How do I make a payment Nawiri weekly,,... Primary care and Mercy Health, CNC, and WLS certifications our service area ohio patient portal,.... Accordance with the Process, call 833.272.7581 to speak to one of their financial resources and/or to! Discover and American Express at Mercy Health East Palestine Primary care and Health.