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Help Paying Your Bill

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Help Paying Your Bill

Home 9 Help Paying Your Bill

Help Paying Your Bill

As part of our mission and commitment to the community, Chino Valley Medical Center is committed to providing quality healthcare that is affordable for our community. If you don’t have health insurance, you may be eligible for a government-sponsored health program, such as Medicare, Medi-Cal, or other state or county-funded healthcare coverage.

If you are not eligible for a government program and meet certain low- and moderate- income requirements, you may qualify for our Financial Assistance Program.  Our Financial Assistance Program provides financial assistance to help qualified patients pay for healthcare based on their financial need. This includes emergency, urgent, or medically necessary care. Patients who qualify get some or all of their costs covered regardless of whether they have healthcare coverage, or are uninsured, or are underinsured.

Have questions?
For more information or if you need assistance, call our Patient Financial Services at 909-292-9401.

Am I Eligible for Financial Assistance?
  • Financial assistance without charge is available to patients whose household income is at or below 400% of the current Federal Poverty Level
  • Patients whose income ranges between 401% – 450% of the Federal Poverty Level qualify for discounted care
How to Apply

Step one:
 Download and print the Financial Assistance application.

Select your language:       

Step two:
 Collect additional documents outlined in the application.

Step three:
Submit your application:

By Mail Chino Valley Medical Center
Patient Financial Services
5451 Walnut Avenue
Chino, CA 91710
In Person Chino Valley Medical Center
Patient Financial Services
5451 Walnut Avenue
Chino, CA 91710

The application is also available by email, in person, or U.S. mail.

For questions or assistance with the process, call our Hospital Business Office at 909-292-9401.

Financial Assistance Documents

English:

    Spanish:

    Chinese:

    Additional Resources
    The Health Consumer Alliance (HCA) is a resource available to patients to help them understand the billing and payment process, as well as Covered California and Medi-Cal Presumptive Eligibility. HCA offers free assistance over-the-phone or in-person. For more information, call 888-804-3536 (TTY 711) or go to www.healthconsumer.org.
    Shoppable Services

    In compliance with the No Surprise Billing Act (Title 45, Section 180.60 of the Code of Federal Regulations), please see our tool of shoppable services available on the hospital website at www.cvmc.com/patients-visitors/price-transparency/.

    Hospital Bill Complaint Program
    The Hospital Bill Complaint Program is a state program, which reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the State of California’s Hospital Bill Complaint Program. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.
    More Help
    There are free consumer advocacy organizations that will help you understand the billing and payment process. You may call the Health Consumer Alliance at 888-804-3536 or go to healthconsumer.org for more information.
    Language Assistance

    For language assistance or help understanding this information, please call or visit our Patient Financial Services: 909-292-9401 (TTY 711), Monday through Friday, 8 a.m. to 4:30 p.m, located at the hospital address shown below. We can also provide this notice in other accessible formats, such as audio.

    Chino Valley Medical Center
    Patient Financial Services
    5451 Walnut Avenue
    Chino, CA 91710