Financial Assistance

Financial AssistanceCatholic Health Initiatives (CHI) understands that paying for emergency and/or medically necessary medical care can be difficult, particularly for patients who lack health insurance. As part of our ongoing commitment to our patients, CHI works hard to help our patients address their financial responsibilities in a way that is fair and sensitive to their circumstances. We have instituted a program designed specifically to help those who find themselves in financial distress.

The Program

The CHI Financial Assistance Policy (available in multiple languages) applies to uninsured/underinsured patients who come to our facilities for treatment. This policy provides financial relief to patients who qualify based on a comparison of their financial resources and/or income to Federal Poverty Guidelines. The program is designed specifically for non-elective care patients whose household financial resources and/or income are at or below 300 percent of the Federal Poverty Level.

To qualify for any assistance, uninsured/underinsured patients will be asked to complete a CHI Financial Assistance Application (available in multiple languages) which includes information relating to household income.

We are committed to working with our patients to establish an appropriate payment plan based on the amount due and the patient’s financial status.

Catholic Health Initiatives Financial Assistance Summary:

Catholic Health Initiatives Financial Assistance Policy:

Catholic Health Initiatives Billing and Collection Policy:

Catholic Health Initiatives Financial Assistance Application:

Providers subject to our Financial Assistance Policy:


For more information, to receive a free copy of these documents, to request a free copy of these documents translated into a language not described, or if you have questions, please contact us at 844-286-5546, by email or visit a Patient Advocate in the Patient Access department located at the 10th Street Entrance.

At your request, a copy of the Financial Assistance Policy and an application form will be mailed to you at no charge. These documents are also available in the Emergency Room and admissions areas of the hospital.


Complete the application and submit it to Medical Eligibility and Counseling Services (MECS) at the address listed below:

CHI St. Alexius Medical Center
ATTN: EES - Financial Assistance Center
P.O. Box 660872
Dallas, TX 75266-0872