Billing & Financial Assistance Resources
Financial Assistance Policy
ClearSky Rehabilitation Hospital of Rio Rancho has a financial assistance policy to assist individuals who may be uninsured or under-insured and meet the medical necessity guidelines for inpatient rehabilitation stays at our hospital.
ClearSky Rehabilitation Hospital of Rio Rancho will file all applicable insurance, Medicare, Medicaid, and third-party liability claims. If you qualify for any state or local funded programs, please provide information regarding your application status. If financial assistance is granted, it will apply to the patient balance after all insurances have settled or to the private pay balance after the private pay discount.
To apply for financial assistance, request an application when being evaluated by our clinical staff before admission. You also may print the application from this link.
Complete and sign the application before your admission and turn it into our staff per the instructions on the application. Approval is not guaranteed.
The Central Business Office will review the application; it will be approved or denied based on the 2023 National Poverty Guidelines. The decision is based on the number of people in your household and the combined gross income of everyone in the household. Your portion of the patient’s responsibility may be partially or fully discounted based on the guidelines. Patients whose family income is equal to or less than 200% of the Federal Poverty Guidelines are generally eligible for free care. Patients whose income is above 200% of the Federal Poverty Guidelines may be eligible for a sliding scale discount. Once the application is received, the Central Business Office will decide and inform you of its decision.
This assistance does not apply to provider or physician fees. Please contact your practitioner directly to discuss their specific financial hardship processes. For questions regarding financial assistance, contact the Central Business Office by email or by calling 505.317.3956.
Financial Hardship Application
A Financial Hardship Application that must be completed to determine if you will qualify for financial assistance. The Financial Hardship Application must be filled out completely with all supporting documentation attached before a determination can be made regarding final financial status. Click here to view/download application.
The Financial Hardship Application information will be reviewed to determine the level of assistance that can be provided. This determination may help with all or a percentage of the patient balance if approved.
ClearSky Rehabilitation Hospital of Rio Rancho will file all insurance, Medicare, Medicaid, and third-party liability claims. If you qualify for any state or local funded programs, please provide information regarding your application status. The Financial Assistance request form is used as a last resource.
Financial assistance will only be in effect for the dates of service currently being rendered. (Does not cover indefinitely.)
THIS APPLICATION DOES NOT APPLY TO PHYSICIAN’S BILLING. YOU MUST CONTACT THE RESPECTIVE PHYSICIAN TO MAKE PAYMENT ARRANGEMENTS FOR THEIR BILL.
Financial Hardship Application Assistance
INSTRUCTIONS ON COMPLETING THE FINANCIAL HARDSHIP APPLICATION
Please complete the application and attach supporting documentation.
- The application must be signed and dated by the patient requesting financial assistance.
- Patient information: Print the patient’s name and fill out the address, responsible party, and how long at the address at the top of the form. Please include the number of people that live in the household, including children and other dependents.
- Banking Information, Savings & Investment/Other Account Balances: List the total balances for checking, savings, or other investment accounts for all individuals in the household. Please include 401k and other pension accounts.
- Income: List the income of everyone in the household. Please list the gross amount of each individual in the household. This includes Social Security Income, retirement income, child support, and any other type of income that is received by anyone in the household.
- Monthly Obligations: This portion of the application includes all household expenses and should only include the monthly payment amount that you pay for each outstanding expense that you have incurred.
- Application must be signed and dated by the patient requesting financial assistance.
- Submit the application to the Finance Department. The Finance Department will review the application and use the Federal Poverty Guidelines to determine if the patient qualifies for any discount. A discount is based on the income and total number of people in the household.
- Please scan and email all documents to Central Business Office email: businessoffice@clearskyhealth.com OR
- Mail a copy of the completed application and all documents to:
ClearSky Health
ATTN: Business Office
5600 Wyoming Blvd. NE, Suite 225
Albuquerque, NM 87109
If you need additional assistance with the application, please call ClearSky Health’s Central Business Office at 505.317.3956.
How to Request an Itemized Statement
An itemized statement or bill may be requested and will be provided within 7-14 business days after the request or the discharge date, whichever is later. The itemized bill or statement will contain details of the individual charges by date. Physician services will not be included in this bill. You should contact the physician who provided the service to obtain an itemized bill or statement for the service provided.
Questions or concerns regarding your bill can be addressed by calling or emailing:
- Central Business Office phone number: 505.317.3956
- Central Business Office email: businessoffice@clearskyhealth.com
