- Applications for charity care are accepted and processed only after all other medical assistance programs are exhausted (insurance, Medicare, Medicaid, CICP, and other federal, state or local programs).
- AVH will assist patients and responsible parties in the completion and submission of any application for medical assistance or charity care determination. However, the patient or guarantor is responsible for providing timely, accurate information in compliance with CICP requirements.
- Falsification of information or failure to provide necessary information will result in denial of eligibility and the patient/guarantor will be held responsible for full payment.
- Applications are available in English (pdf) or at AVH in the admissions department.
Patients needing assistance in completing the application can contact an AVH representative at 970.544.1543. Staff is available Monday - Friday from 8:00 a.m. to 4:00 p.m. Mountain Time.
In instances where charity care is not approved, AVH would be happy to discuss a payment plan with you.
CICP Charity Application