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Patient Financial Services

At Henry County Health Center we have a team of insurance specialists/financial counselors who are dedicated to assisting our patients with services which include:

  • Filing insurance claims
  • Interpreting individual or group insurance coverage
  • Collecting payments
  • Providing itemized billing upon request
  • Assisting patients in applying for HCHC’s Financial Assistance Program
  • Referring private pay patients to appropriate staff who can assist them in signing up for Presumptive Medicaid or The Bank Loan Program to cover medical expenses
  • Providing estimates for future services (including cost of procedure/out of pocket)

Patient Financial Services hours are 8:00 am to 4:30 pm Monday through Friday.

We have payment boxes conveniently located in the main lobby, Emergency Department and at the north entrance located next to the Patient Financial Services window.

For questions please call 319-385-6140.

Low Fixed Rates
0% Interest Rate (to qualified applicants)
Quick & Easy Application
Click here to access the loan application form

Financial assistance Policy & apPLICATION

Please Click Here to download the Financial Assistance Policy Summary & Application. Applications can also be picked up at each hospital location.

Click Here for the complete Financial Assistance Policy.

Collections Policy

Please Click Here to view our Patient Balance Policy.

Please Click Here to view our Charity Matrix.

understands there are situations when patients cannot pay for the services provided. If you need help paying for medical services, you may qualify for financial assistance from the health system. No one will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule available based on family size and income.

Where to apply and how to request a free copy:

Henry County Health Center
Patient Financial Services
407 S. White St.
Mount Pleasant, IA 52641

Request a mailed copy by calling 319-385-6140.

Who is eligible?

  • Insured and uninsured patients receiving medically necessary or emergency care

  • Patients whose household income is between 200% and 300% of the Federal Poverty Guidelines that are updated each year


Patients with no insurance who qualify for financial assistance cannot be charged more than the amount generally billed to patients who have insurance.

How to apply:

  • Complete and sign all sections of the Financial Assistance Application on the back of this summary.

  • Provide this information:

    • Paycheck stubs from the last two months for everyone living in your household above age 18 (excluding high school students)

    • Social Security income. You can use a copy of your most-recent check, bank statement or benefits letter.

    • Most-recent state and federal income tax forms

    • If you are unemployed: state unemployment claims AND final paycheck stub from your last job

    • Denial letter from the Department of Human Services

If you have any questions or concerns, please feel free to call Henry County Health Center at 319-385-6163.