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Financial Assistance Application Form - AtlantiCare - atlanticare 2025

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The document is a financial application form that requires proof of income, specifically two pay stubs, to be submitted alongside personal information such as the patient's name, social security number, and family size. It outlines the process for applying for financial assistance, including income criteria and potential programs for additional consideration like Charity Care and Medicaid. The form also includes sections for approval status and reasons for denial.

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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.

How many locations does the Atlantic health system have?

We offer more than 550 conveniently-located care sites across New Jersey. HospitalsOur hospitals are committed to compassionate, patient-centered care for adults and children. Urgent Care Timely care for the whole family, with locations conveniently located throughout northern and central New Jersey.

Does AtlantiCare have an app?

Stay connected to your health records with the HealthLife patient Portal app. This free tool lets you securely access your online health records for AtlantiCare Physician Group and Hospital Services using your mobile device. Download this free app today!

How many locations does AtlantiCare have?

AtlantiCare is an award-winning integrated healthcare system based in Egg Harbor Township, New Jersey, whose team of more than 6,500 serves the community in over 110 locations in Atlantic, Burlington, Camden, Cape May, and Ocean counties of southern New Jersey.

Is AtlantiCare owned by Geisinger?

This mutual agreement includes a number of conditions for closing and may take six to 18 months to finalize. Until this process is complete, AtlantiCare remains a part of the Geisinger system.

Who is AtlantiCare affiliated with?

AtlantiCare Cancer Institute Announces Affiliation with Cleveland Clinic Cancer Institute.

What is the phone number for AtlantiCare benefits?

AtlantiCare Benefits Service Center 1-800-211-3252 Monday through Friday, 8:00 am 6:00 pm Saturday, 8:00 am 5:00 pm You can access the AtlantiCare Benefits Service/Enrollment Site to make your elections via myadp.com . Navigate to the Benefits tab and click Health and Welfare.

What documents do I need for Charity Care in NJ?

Charity Care Income Criteria and Required Information Valid Identification. Drivers License Valid (unexpired) State/County ID. Social Security card. Proof of New Jersey Residency for Date(s) of Service. Utility bill for date of service. Valid (unexpired) drivers license with current address. Income Information.

Is AtlantiCare a level 1 trauma center?

It was also the 31st anniversary of when AtlantiCare Regional Medical Center Atlantic City Campus opened the regions only state-designated Level II Trauma Center.

Financial Assistance Application Form - AtlantiCare - atlanticare 2025

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