Financial Assistance

UNC Health Southeastern’s Medical Financial Assistance program provides financial assistance for qualifying patients who need help paying for emergency or medically necessary care they receive at UNC Health Southeastern hospital, clinics or centers.

Patients must fill out an application to apply and must meet the eligibility requirements listed below to qualify.

Who is eligible for Financial Assistance and what are the requirements?

The program helps low-income, uninsured, or underserved patients who need help paying for all or part of their medical care. Patients are eligible for Financial Assistance when their Family Income is at or below 200% of the Federal Poverty Guidelines (FPG). Evaluation of other criteria may be required. Patients should consult with a Financial Counselor to determine eligibility and for assistance applying. Any patient who meets special circumstance criteria may be eligible for financial assistance.

Patients who are eligible for medical financial assistance will not be charged more than amounts generally billed (AGB) for emergency or other medically necessary care to patients with insurance (AGB, as defined by IRS Section 501(r)).

Sliding Fee Policy [PDF]

What does the program cover?

The Medical Financial Assistance program covers medically necessary care provided at a medical office, hospital, or pharmacy, or provided by a UNC Health Southeastern physician or provider. Not all costs are covered, such as premiums and dues; optical and hearing aids; and cosmetic, non-urgent or elective care. A complete exclusion list can be found in the Financial Assistance policy online.

How do I Apply?

You can get an application from any of the following sources:

Please mail completed applications (with all required documentation and information specified in the application instructions) to:

Patient Financial Services
Attn: Financial Counselor
2600 N. Elm Street
Lumberton, NC 28358

You may also hand deliver your documents to the person at the Hospital or Clinic registration desk.

Your application, with required documentation is then reviewed. If there is something missing, we will notify you and provide a chance to provide it, so the application can be considered.

Is there language assistance?

UNC Health Southeastern provides language assistance. Please see the non-discrimination policy for more information.

How can I get a copy of UNC Health Southeastern’s Financial Assistance Policy?

You can download our Financial Assistance Policy here. You can also ask for a free copy of UNC Health Southeastern’s Medical Financial Assistance policy by calling (910) 735-8485 or mailing a request to 2600 Elm Street, Lumberton, NC 28358.

For help or questions about the Medical Financial Assistance application process, please call (910) 735-8485, or inquire at our registration desks in the hospital or clinics.

Contact Us

UNC Health Southeastern Financial Services
2600 North Elm Street
Lumberton, NC 28358

Tel. (910) 671-5047
Fax. (910) 618-9086.
Email. customerservice@srmc.org

Office Hours: Monday - Friday 8:00am - 5:00pm