{"id":273,"date":"2015-08-19T17:15:59","date_gmt":"2015-08-19T17:15:59","guid":{"rendered":"http:\/\/new.medicount.com\/?page_id=269"},"modified":"2015-09-15T18:21:55","modified_gmt":"2015-09-15T18:21:55","slug":"hardship-application","status":"publish","type":"page","link":"https:\/\/medicount.com\/es\/hardship-application\/","title":{"rendered":"Hardship Application"},"content":{"rendered":"

Hardship Application<\/h2>\n

This is an application for financial hardship consideration. This application will be utilized to determine eligibility for uncompensated services based on established criteria. By submitting this application you hereby certify that the information provided below is current and accurate to the best of your knowledge. You also certify that you have utilized available agencies (Medicare, Medicaid, and any other commercial insurance) that provide assistance which may be available for payment of your ambulance charges. Payment received from said agencies will be assigned to your ambulance provider. Information provided on this application will be utilized for financial hardship consideration only. Parties privileged to this information will include transporting ambulance provider and third party billing company only.<\/p>\n

HardshipApplication&WaiverRequestForm-07212015<\/a><\/p>\n

Formulario de Informaci\u00f3n de Seguro para Transporte de Pacientes\nPara procesar su reclamo, por favor complete el formulario a continuaci\u00f3n con la informaci\u00f3n de su seguro. Solo complete los campos que sean aplicables a su cobertura<\/p>\n

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You also certify that you have utilized available agencies (Medicare, Medicaid, and any ...","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"template-blank-4.php","meta":{"content-type":"","footnotes":""},"class_list":["post-273","page","type-page","status-publish","hentry","no-post-thumbnail"],"yoast_head":"\nHardship Application - Medicount - Ambulance and EMS billing services and software.<\/title>\n<meta name=\"description\" content=\"HIPPA compliant EMS and ambulance billing software service, with complete hospital integration, SSAE auditing, and ePCR Partnerships\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicount.com\/es\/hardship-application\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hardship Application - 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