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Patient Information: Payment Contracts

Patients not able to utilize the Prompt Payment Discount can establish extended payment plans that are interest free.  All patients can qualify for a payment contract as outlined below.
 

Balances up to $500 to be paid within 12 months.

Balances $501 to $2,000 to be paid within 24 months.

Balances over $2,000 to be paid within 36 months.


The initial contract must be established in writing by completing the Hillsdale Hospital Payment Contract form, which can be obtained through the Financial Counselor (517) 437-5222 or Patient Accounting Office (517) 437-8335.

The payment contract must be recalculated to meet the above-mentioned terms if account balances are added to the contract.  Accounts may be added and payment terms adjusted upon mutual agreement of both parties.  A written confirmation will be mailed to the contract holder upon receipt of a change request.

Monthly statements will be mailed to the responsible party.  Payments may be made by cash, check, Master Card, VISA, or Discover.

If the monthly payment is not received in accordance with the terms, the responsible party will be mailed a contract delinquency letter within 15 days after the payment was due.  If the payment is not received by month end, Hillsdale Hospital may terminate this agreement and refer the remaining balance to a collection agency for further action.


Hillsdale Hospital • 168 South Howell Street • Hillsdale, Michigan 49242 • 517.437.4451
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