The Financial Services department assists patients through multiple areas of the hospital including: Financial Counselors, Cashier, Customer Service Call Center, Central Registration, Pre-Registration, Business Office, Scheduling and Operators.

If you have general questions or concerns about your hospital bill, call our Customer Service number at (256) 737-2986, Monday-Friday, 8:00 am – 4:30 pm.

Financial Services

Insurance / Medicare

Prior to hospital admission, you will be asked to provide your insurance identification card. Our staff will verify your coverage, review your benefits and estimate the amount due from you. You will be responsible for deductibles, copays and/or charges above that coverage and will be asked to pay those amounts prior to or during your stay.

While we will strive to optimize your insurance coverage, patients are ultimately responsible for charges incurred when using hospital services. A financial counselor may visit your room during your stay to explain your financial obligation and assist you in establishing payment arrangements. If you have questions, assistance may be obtained by calling one of the following:

For last names beginning with A-L, call (256) 737-2678
For last names beginning with M-Z, call (256) 737-2677

Price Transparency – Patient Price List

Professional Fees

Your hospital bill does not include fees for the professional services of your physicians, anesthesiologists, surgeons or consulting physicians. You may also receive bills from specialists, which include radiologists or pathologists who bill separately for their services.

Charity Policy and Application

Charity financial assistance is available to eligible patients receiving medically necessary services. You are required, however, to complete the Financial Assistance Application and submit supporting documentation to verify your need for financial assistance.

Plain Language Statement

Cullman Regional will provide Financial Assistance for eligible patients who require emergency or medical urgent services. The eligibility is based on 200% of the Federal Income Poverty guidelines which are generally updated by the government in February of each year (click here for the guidelines). Proof of income and other documentation is necessary to determine eligibility; however, administrative waiver may be granted under unusual circumstances. A free copy of the application may be obtained in one of 4 ways:

  • Online (click here to apply online)
  • Printable copy  (click here to download a printable copy)
  • By mail: Call our Customer Service Representative at (256) 737-2986 or contact our Financial Counselor at (256) 737-2986 or (256) 737-2677.
  • In person at Cullman Regional on the Ground Floor of the main Hospital. The hospital is located at 1912 Alabama Highway 157, Cullman, AL 35058.
  • A Spanish Translation of the Financial Assistance Policy, Financial Assistance Application Form, and Plain Language Summary is available by clicking the Spanish tab above.

Please contact a Financial Counselor, individuals with the hospital department who provide information about the Financial Assistance Policy, if you need information about the Financial Assistance Policy, assistance in understanding or completing an application. Once a complete application is submitted, it will be reviewed by hospital management. You will be notified by mail if approved or denied.

Note that Financial-assistance policy individuals or payers are never charged more than the amounts generally billed to other individual or payers. Also on this site you can find current providers that have privileges at Cullman Regional, and could potentially provide you medical care; however, only employed providers of Cullman Regional are eligible for discounted or free care under this policy.

  • For a complete list of providers (physicians and practitioners) who are covered by the hospital’s Financial Assistance Policy, please click here.
  • For a complete list of medical staff members who have privileges at Cullman Regional but are not covered by Cullman Regional’s Financial Assisstance Policy, click here.

Identifying Patients Needing Financial Assistance

  • At any time during an initial financial screening and continuing collections process, patients who claim to lack the ability to pay will be offered a Financial Assessment Application.
  • A hospital representative will review and explain the process. We assign patients Financial Counselors by the last name. If your last name begins with A-L, call (256) 737-2678, if your last name begins with M-Z, call (256) 737-2677, Monday-Friday, 8:00 am – 4:30 pm.

Eligibility Criteria

Cullman Regional uses the Federal Poverty guidelines to determine eligibility for charity consideration. The guidelines are based on annual income and family size, and are adjusted by the government annually. You may qualify for a full or partial discount on charges. Patient’s annual household income will be compared to eligibility guidelines based upon 200% of Federal Poverty Levels (FPL). Click here for the Guidelines, or contact the Patient Financial Services Department at (256) 737-2986.

Applying for Financial Assistance

  1. The Financial Assessment Application must be complete in its entirety.
    • Click here to complete an application online.
    • Within 10 days of receipt, the patient must return the application and supporting documents.
    • Additional time may be granted in extenuating circumstances.
  2. Supporting documentation includes, but is not limited to:
    • Click here for a printable copy the application.
    • Most recent year’s income tax return
    • Copy of Social Security cards or formal identification for all household members included in income guidelines
    • Most recent month’s checking and savings account statements
    • Documentation of all monthly payment obligations reported on application
    • Proof of income: paycheck stubs or a notarized memo from employer. Employer’s name, address and phone number must be included on proof of income.
    • Notarized verification of financial support received from friends, family, churches, charitable organizations, etc.
    • Written verification of a pending disability case

Exclusions to Supporting Documentation Requirements

  1. Administrative Determination
    • Cullman Regional Administration may, on a case-by-case basis and not with prior determination, exempt a patient from requested documentation in the event of extenuating circumstances.
    • Details of extenuating circumstances will be documented in the financial counselor’s summary and recommendations.
  2. Medicaid Recipients
    • Patients with Medicaid who exhaust their Medicaid coverage for a specific aide category, indicated on the Medicaid Remittance Advice, will receive a 100% adjustment to the specified account balance. Cullman Regional’s Business Office will confirm that the recipient ID was correct on the Medicaid claim.
    • For patients under 21 years of age, the Cullman Regional Business Office will confirm that there is no Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Referral that should be used on the claim.
  3. Good Samaritan Health Clinic Patients
    • Those with a qualifying Good Samaritan Health Clinic Patient Identification Card in effect for the date of hospital service will not be required to complete the Financial Assessment Application.
    • The Good Samaritan Health Clinic will maintain supporting documentation.

Charity Review and Assessment

  1. Financial counselors will review your application with supporting documents, obtain a consumer credit report, summarize the information and recommend approval or denial. Your annual household income will be compared to eligibility guidelines based upon 200% of Federal Poverty Levels.
  2. Cullman Regional’s Patient Financial Services Manager, Patient Financial Services Director and/or Chief Financial Officer will review and assess recommendations.
  3. A financial counselor will notify you of your eligibility and explain any payment required.


Cullman Regional brindará asistencia financiera a los pacientes que califiquen que necesiten servicios de emergencia o de urgencia médica. La elegibilidad se basa en el 200% de los lineamientos que definen el Índice Federal de Pobreza, que generalmente el gobierno actualiza en febrero de cada año (haga clic aquí para conocer los lineamientos). Para determinar la elegibilidad es necesaria la prueba de ingresos y otra documentación; sin embargo, en circunstancias inusuales, puede concederse la renuncia administrativa. Se puede obtener una copia gratuita de la solicitud de 4 maneras:

Por favor, contacte al asesor financiero si necesita ayuda para entender o completar una solicitud. Una vez que se envía una solicitud completa, la gerencia del hospital la revisará. Se le notificará por correo si la misma fue aprobada o rechazada.

Considere que a los solicitantes de ayuda financiera nunca se les cobra más de los montos que generalmente se facturan a otras personas o pagadores. Asimismo, en este sitio puede encontrar proveedores actuales que tienen privilegios en Cullman Regional y que potencialmente podrían brindarle atención médica; sin embargo, sólo los proveedores empleados de Cullman Regional califican para recibir descuentos o atención gratuita en virtud de esta póliza.

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