1. Home
  2. Patient & Visitor Information
  3. Insurance & Payment Information
  4. Financial Assistance Program

financial assistance program

Our mission at DeKalb Medical is to deliver high quality healthcare services that improve the health and well-being of the patients we serve. The facilities of DeKalb Medical include the North Decatur, Hillandale and Downtown Decatur hospital locations.

DeKalb Medical understands that not all patients have the ability to completely pay their healthcare bills. To eliminate financial barriers for our patients who are uninsured, under insured, or have limited means to pay for emergency and medically necessary services provided in our hospitals and in our hospital outpatient facilities, we offer a fair and equitable Financial Assistance Program (FAP) to patients qualifying under the Federal Poverty Level guidelines (FPL).  

DeKalb Medical will provide emergency and medically necessary hospital medical care to all emergent patients, without regard to race, creed, gender, color, national origin, immigration status or other characteristics covered by law. DeKalb Medical will provide this care to patients regardless of their insurance coverage, or their ability to pay for these services or their eligibility under the FAP.

The FAP does not apply to medical services provided by physicians at DeKalb Medical. Patients may receive a separate bill from the primary treating physician as well as for professional services provided by radiologists, pathologists, anesthesiologists, emergency room and other treating physicians.

The FAP is not a substitute for personal responsibility. Patients are expected to cooperate with DeKalb Medical in determining eligibility for various programs.

What is covered under the Financial Assistance Program of DeKalb Medical?

DeKalb Medical provides a Minimum Charitable Allowance (MCA) for all uninsured patients.  The MCA is an allowance that approximates the difference between the charges for emergency and medically necessary services and the “Amounts Generally Billed (AGB)” to and collected from Medicare and/or commercial health insurance companies. This allowance is referred to as the Uninsured Adjustment on the patients’ billing statements.

The MCA does not apply to deductible and co-insurance amounts.

DeKalb Medical uses a 12 month “look-back” period to determine the AGB.  After a patient’s’ account is reduced by the MCA, the patient is responsible for the remainder of the outstanding amount.

Further levels of financial assistance and charity care are available as determined by our FAP and the FPL guidelines. The patients of DeKalb Medical who have family household resources meeting the FPL guidelines may be eligible for charity care and discounted services.

DeKalb Medical may adjust the eligibility criteria for the FAP periodically based upon the Community Health Needs Assessment (CHNA) conducted for DeKalb Medical and as necessary to comply with applicable laws and regulations.

How to Apply for Assistance

If you are having trouble paying for some or all of your health care services received at DeKalb Medical, please speak with a member of our Financial Counseling team at 404.501.5519.

To be considered for our FAP, uninsured and under insured patients must complete and disclose any sources of insurance and/or means of payment to establish proof of need.  A completed FAP application must include all required supporting documents and income verification information to help the Financial Counseling team of DeKalb Medical determine the eligibility for full or partial financial assistance.

In person: The DeKalb Medical Financial Counseling Departments are located by the main information desks at the North Decatur and the Hillandale hospital locations.

By phone: 404.501.5519

Financial Assistance Checklist

Identification - The original or a certified copy of at least one of the following documents is required:

  • Passport
  • Driver’s license
  • State of Georgia ID card
  • School picture ID
  • Visa or Residence Alien Card (if applicable)

Proof of Residency – One to three of the following documents showing your current street address is required:

  • One to three utility bills such as power bill, gas bill, water bill and/or telephone bill
  • Mortgage contract
  • Lease Contract
  • Rent receipt (showing current address)
  • Food stamps letter
  • Voter registration documentation
  • Other business documents that verify your place of residency:
    • Credit card statements
    • Latest IRS tax return
    • Medicaid letters
    • Student letters from school
    • Bank statement
    • Mortgage statement
    • Check stubs showing your address
  • P.O. Box addresses do not demonstrate residency

Proof of income – one of the following is required:

  • One to three current pay check stubs (patient and spouse)
  • Latest IRS tax return
  • Unemployment claim
  • Department of Labor (DOL) wage inquiry
  • Recent bank statements, if patient is living off saving
  • A letter from an employer on company letterhead stating the rate of hourly pay, the total amount paid each pay period and how often the employee is paid
  • Any decision letter indicating the patient is receiving unemployment compensation, Medicaid, Social Security disability or general assistance
  • Food stamps letter and pay check stubs (if applicable)
  • Verification of homelessness or a letter from a shelter on company letterhead
  • Other business documents showing how the patient is being supported

Proof of number of dependents – one of the following is required:

  • Previous year’s income tax return (most recent)
  • Any decision letters indicating that the patient has legal responsibility for the child, such as, court ordered guardianship papers or custody papers
  • Birth certificate for each child age 18 and younger

contact us

contact us online bill pay access my account

2701 North Decatur Road
Decatur, GA 30033

Contact Us Online
in the News
Visit Press Releases