Financial Assistance Options
Need help paying your medical bill? We are here to help
Medical bills can sometimes be overwhelming. That is why we offer a few payment programs to help based on your unique situation:
Elevate
Bellin Health has contracted with Elevate a company that can assist self-pay patients in applying to determining if they qualify for coverage.
Payment Plans
Payment in full is expected within 30 days from the statement date. If you are unable to pay within 30 days, payment arrangements can be made in the following ways:
- Via your Emplify Health MyChart account.
- By calling Emplify Health Customer Financial Service at (608) 775-8660 or (800) 362-9567, ext. 58660. Hours are 7:30 a.m. to 5:30 p.m. Monday through Friday.
Payment may be made with cash or by credit card (Visa, MasterCard or Discover) with patient registration at time of pre-admission, admission or before being discharged. Payment may also be made upon receipt of your bill to the Bellin Cashier Office.
2020 S. Webster Avenue
Green Bay, WI 54301
United States
Our financial assistance program is available to patients who show financial need. Find additional information and applications below.
Application Forms
Financial Assistance Application
Our financial assistance program is available to patients who show financial need. Find additional information and applications below.
Financial Assistance Application - English
Financial Assistance Application - Spanish
National Health Service Corps
The following Bellin Health clinic locations participate in the National Health Service Corps (NHSC) Sliding Fee Discount Program: Bellin Health Oconto, Bellin Health Marinette, Bellin Health Oconto Falls, Bellin Health Crivitz, Bellin Health Peshtigo, Bellin Health Algoma, Bellin Health Kewaunee, Bellin Health Daggett, Bellin Health Iron Mountain, Bellin Health Escanaba and Bellin Health Luxemburg. As an NHSC participating site, no individual will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule available based on family size and income.
NHSC Financial Assistance Application
NHSC Financial Assistance Application - Spanish
Financial Assistance Policy
Financial Assistance Policy - English
- Appendix 2: Discount chart based on income and asset thresholds, and the uninsured discount rate
- Appendix 3: Covered providers and departments
- Appendix 4: Amounts Generally Billed (AGB) percentage
- Appendix 5: Public access to documents
Financial Assistance Policy - Spanish
Plain Language Summary
Plain Language Summary - English
Plain Language Summary - Spanish
Self-Pay Billing & Collection Policy
Self-Pay Billing & Collection Policy - English
Self-Pay Billing & Collection Policy - Spanish