We know that paying for medical care can be difficult for many families. As part of Colorado Canyons Hospital & Medical Center’s commitment to our patients, we provide counseling and assistance to help individuals apply for available programs that may help cover unpaid hospital bills.

• Patients who are uninsured or underinsured may qualify for PEAK (Colorado Medicaid) or CICP (Colorado Indigent Care Program). We can provide the necessary information for you to apply for assistance.
• If you are not eligible for PEAK or CICP, our Financial Counselor can discuss other options available to you, such as a discount at the time of service for self-pay patients or monthly payment plans.

I don’t qualify for PEAK or CICP, how do I apply for financial assistance?

An application is available from the hospital Registration Department or from a Financial Counselor. It is also available below. Complete and return it as soon as possible.

How is eligibility for financial assistance determined?

Completing the application is not a guarantee that you will be approved for financial assistance. We will review the details of your application which include current income, expenses, and family size. Be sure to sign the application, provide copies of required documentation, and submit the application soon. You will be notified of our decision, in writing, within 30 days of receipt of the completed application.

What happens to my account while I’m applying for assistance?

The collection process will continue until your financial assistance status is determined. Please make arrangements with our Financial Counselor as soon as possible.

Colorado Canyons Hospital & Medical Center Application Forms