Home
Forms Library
Cleveland clinic hcap phone number

Cleveland clinic hcap application 2025

cleveland clinic hcap phone number Preview on Page 1

See details

4 out of 5

54 votes

The document outlines the financial assistance programs available for residents of Ohio, Florida, and Nevada, specifically through the Ohio Hospital Care Assurance Program (HCAP) and the facility's General Financial Assistance Policy. It details eligibility criteria based on income levels relative to the Federal Poverty Guidelines (FPG), provides a sliding scale for discounts on medical services, and mentions special considerations for exceptional medical circumstances. Additionally, it explains how to apply for assistance, obtain policy information, and includes application instructions.

Here's how it works

01. Edit your cleveland clinic hcap phone number online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send hcap cleveland clinic via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out cleveland clinic hcap application with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Cleveland Clinic HCAP application in the editor.
Begin with Section One: Patient Information. Fill in your full name, address at the time of service, and other required details such as Social Security Number and Date of Birth.
In Section Two: Family Income, provide the monthly income for yourself and any family members. Attach proof of income such as pay stubs or award letters for verification.
Proceed to Section Three: Family Information. List all family members living in your household along with their dates of birth and relationship to you.
Finally, review all information for accuracy, sign the application, and ensure it is dated before submission.

Start filling out your Cleveland Clinic HCAP application today using our platform for free!

See more cleveland clinic hcap application versions

We've got more versions of the cleveland clinic hcap application form. Select the right cleveland clinic hcap application version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2023	4 Satisfied (25 Votes)
2013	4 Satisfied (54 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Who qualifies for HCAP in Ohio?

Compensation Key Employees and OfficersCompensationOther Mihaljevic Md Tomislav (Director, Pres, Ceo Ccf) $6,205,435 $51,315 Kottke Marchant Md Kandice (Physician (2022 Retiree)) $2,926,750 -$682,117 Ruggieri Md Paul (Physician (2022 Retiree)) $2,444,796 -$667,687 Rowan David (Dir, Sec, Chief Legal Off Ccf) $2,288,096 $47,90522 more rows

How to apply for HCAP in Ohio?

As a participant in the HCAP Program, we offer emergency and other medically necessary services in our hospitals free of charge if you are a resident of Ohio and either (1) you are currently an eligible recipient of the General Assistance or the Disability Assistance Programs or (2) your income is at or below 100% of

Who is the highest paid Cleveland Clinic employee?

The Chronic Pain NeuroRehabilitation Program combines the know-how of medical, physical and psychological healthcare providers to help your chronic pain. You can join this program if your pain lasts longer than three months, is taking over your life and hasnt improved with surgery and medication.

What does Cleveland Clinic HCAP cover?

Top-paid Greater Cleveland nonprofit employees Dr. Tomislav Mihaljevic. Dr. Brian J. Dr. Allison T. Dr. Cliff Megerian. David Rowan. Organization: Cleveland Clinic Foundation. Dennis Laraway. Organization: Cleveland Clinic Foundation. Dr. Lars Svensson. Dr. Rohit Chandra.

What is HCAP at Cleveland Clinic?

HCAP is Ohios Hospital Care Assurance Program. HCAP is Ohios version of the federally required Disproportionate Share Hospital program. HCAP provides funding for hospitals that provide a disproportionate share of basic medically necessary hospital level services to qualified patients.