Financial Forms

Financial Forms

The financial forms that you are asked to fill out are very important; they allow St. Mary's Hospital to bill your insurance carrier directly. They also show your agreement to be financially responsible for any treatment or service you may receive that is not covered by your insurance, to provide for the release of information to third-party payers, and State/Federal agencies, as required by law. Many insurance companies require you to pay a portion of the hospital bill including deductibles and co-pays. Deductibles and co-payments are expected to be paid at the time of registration. St. Mary's has Patient Financial Counselors who may contact you during your hospital stay to discuss your individual financial liability.

The Hospital accepts cash, money orders, checks and credit cards in payment for services rendered. If you are unable to make payment in full, the Hospital will work with you to arrange a payment schedule. If you have any questions, please call Patient Accounts at 973-365-4810.