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## Resources

# Financial Assistance

Please take a moment to download and review the following forms. They contain information on financial assistance offered by PRMC to help pay for your care.

PRMC Financial Assistance & Social Responsibility Spanish Version

PRMC Financial Assistance Application Form Spanish Version

PRMC Plain Language Summary Spanish Version

Providers affiliated with Pratt Regional Medical Center who will provide emergency and Medically Necessary care the terms of PRMC's Financial Assistance Policy include:

#### Provider | #### Phone Number
#### Internal Medicine Provider *Includes Professional and Technical Fees | #### 620-672-7415
#### Surgicenter Providers *Includes Professional and Technical Fees | #### 620-672-6454
#### Bone and Joint Providers *Includes Professional and Technical Fees | #### 620-672-1002
#### Emergency Medicine Providers *Includes Professional and Technical Fees | #### 620-672-7451
#### Infusion/Wound Care *Includes Technical Fees | #### 620-770-4117

Providers affiliated with Pratt Regional Medical Center who will not be covered under the terms of PRMC's Financial Assistance Policy include:

1. Anesthesia Services (all professional and technical fees)
2. Radiologist Fees (all professional fees)
3. Pratt Family Practice Provider Fees (all professional fees)
4. Pathologist Fees (all professional fees)
5. Urgent Care Services (all professional and technical fees)