Patient Rights

Patient Rights

Resources for Patient Rights

Financial Assistance

Roundup Memorial Healthcare's mission and values encourage reaching out to people in the community we serve to provide care to all persons, including individuals and families with financial limitations. We are committed to provide financial assistance to persons who have health care needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay, for medically-necessary care based on their individual financial situation.

If you are unable to pay for your medical bills, please apply for our financial assistance program.

  • We can help you with the application.
  • All personal information is kept confidential.
  • The amount of financial assistance is different for each person or family, depending on your financial circumstances.
  • You may apply for financial assistance for co-pays and deductibles.

Free and Discounted Care Guidelines

Financial Assistance is available to those who qualify, with gross household income up to 200% of the Federal Poverty Levels.  For more information or to request financial assistance please download and print the following application:

FinancialAssistReq

HIPAA Notice of Privacy Practices
Interpreter Services
MOON form (Medicare Outpatient Observation Notice)

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