Financial assistance

Financial assistance program

Count on ProHealth to provide emergency care and other medically necessary care to everyone who lives in our service area, regardless of ability to pay. If you can’t afford your tests or treatments, apply for the ProHealth Care Financial Assistance Program.

Am I eligible?

You may be eligible for financial assistance if you:

• • Live in the ProHealth Care service area, which includes areas of Dodge, Jefferson, Racine, Walworth and Waukesha counties.
  • Meet income guidelines.
  • Don’t have other ways to pay for medically necessary services.

How to apply

Whenever possible, apply for financial assistance before you receive care. Download a financial assistance application [PDF] or get one from the registration desk at either of our hospitals or any ProHealth Medical Group location. Or, call 866-432-7855 and ask to have a copy mailed to you.

Return the completed application

Completed applications can be mailed to:

ProHealth Care
N17W24100 Riverwood Dr.
Suite 200
Waukesha, WI 53188

Completed applications can also be delivered to the address above, dropped off at any ProHealth Medical Group clinic or left with a cashier at ProHealth Oconomowoc Memorial Hospital or ProHealth Waukesha Memorial Hospital.

If you apply for assistance before receiving care, we’ll let you know if your application is approved within five business days of receiving it.

If you apply for assistance after receiving care, we’ll let you know if your application is approved within 10 business days of receiving it.

Financial assistance policy

Read our complete financial assistance policy [PDF] for details about eligibility and requirements.

ProHealth Care uses the “look-back” method to calculate the amount generally billed (AGB) as required by federal law. The AGB is the maximum amount we will collect from a patient who is eligible for financial assistance as outlined in our financial assistance policy.

The AGB percentage is based on all claims allowed by Medicare and private health insurers over a 12-month period, divided by the associated gross charges for those claims.

The rates from fiscal year 2023 (Oct. 2022 through Sept. 2023) are noted below:

• • 26.08%  ProHealth Oconomowoc Memorial Hospital
  • 26.36%  ProHealth Waukesha Memorial Hospital and ProHealth Waukesha Memorial Hospital-Mukwonago

Payment plans

ProHealth Care Bill Pay makes it easier for you to manage your medical bills. When you set up an account, you can use the online resource to create your own payment plans and pay according to a customized schedule that works for you.