Northwest Florida Community Hospital’s Financial Counselor is available Monday through Friday from 8:00am to 4:30pm CST to assist you with your financial needs.
Northwest Florida Community Hospital and its staff are dedicated to serving the community’s healthcare needs.
At Northwest Florida Community Hospital we provide emergent services and most medically necessary services regardless of financial status or the patient’s ability to pay.
Payment on accounts will be pursued consistently, without discrimination.
In the event a patient is unable to pay or unable to pay the full balance we offer financial assistance and payment plan options.
Financial Assistance / Charity Care
How to Request Assistance
Begin by obtaining a Financial Assistance Application from any of the following methods:
- Click here to download the Financial-Assistance-Application
- Visit the Financial Counselor in person to request a Financial Assistance Application
- Call the Financial Counselor at (850) 415-8165 to request an application be mailed to you
Complete and return the Financial Assistance Application with all the applicable documentation indicated (the most recent copies of your W-2, Tax Returns, Pay Stubs and Bank Statements) to the Financial Counselor for review.
What to Expect
Your application will be reviewed and a decision will be communicated to you. All information is confidential. Eligibility is calculated based on the Federal Poverty Guidelines and the indicators listed below.
- Family Size
- Income Guidelines
If you have questions or need assistance completing the application please contact the hospital’s Financial Counselor.
Our partner Repaytient offers interest-free payment plans that allow you to pay your full out of pocket balance over time in a budget friendly manner.
To view your payment options please go to https://repaytient.com/enrollment/ or call
812-329-5045 to speak to an enrollment specialist.