The Valley Hospital offers financial assistance to eligible patients who are uninsured, underinsured, ineligible for a government healthcare program, or otherwise unable to pay for medically necessary care based on their individual financial situation. Patients seeking financial assistance must apply for the program.
Patient Financial Services counselors are available to address questions related to the Financial Assistance Program. Call 201-291-6080 Monday through Friday from 8:30 a.m. to 4:30 p.m.
You can also learn more about financial assistance through the New Jersey Hospital Care Payment Assistance Fact Sheet.
Eligible services include emergent or medically necessary services provided by the hospital. Eligible patients include all patients who submit a financial assistance application (including requested documentation) and are determined to be eligible for financial assistance by the Patient Financial Services Department.
How to Apply
Download the following forms:
New Jersey Hospital Care Assistance Program Application for Participation
The Valley Hospital Financial Assistance Policy Application
You may also request these applications through the Patient Financial Services Department:
- By phone at 201-291-6080
- By mail at 223 North Van Dien Ave., Ridgewood, New Jersey, 07450 (Attn: Patient Financial Services)
- In person at The Dorothy B. Kraft Center, 15 Essex Road, Paramus
Return all financial assistance application documents, either by mail or in person, to the Patient Financial Services Department (see addresses above).
Determining Your Eligibility
Eligibility for financial assistance will be determined based on a patient’s household income and number of members in the household, also known as the Federal Poverty Level (FPL). If you and/or the responsible party’s combined income are at or below 500% of the FPL, your hospital care may be fully or partially covered. Discounts are based on a sliding scale used to determine the percentage reduction of charges that will apply.
No person eligible for financial assistance under the Financial Assistance Policy will be charged more for emergency or other medically necessary care than amounts generally billed to individuals who have insurance covering such care. If you have sufficient insurance coverage or assets available to pay for your care, you may not be eligible for financial assistance. Please refer to the full Policy for a complete explanation and details.
This summary, the Financial Assistance Policy, and Financial Assistance applications are available in English, Spanish, Korean, Chinese, and Russian at the locations listed above. For patients speaking other languages, interpreters will be made available to clearly communicate the Policy and provide assistance in completing the necessary forms.
Patients needing financial assistance may qualify for the State Charity Care Assistance Program. If you apply for financial assistance, you will be required to supply, at a minimum, a copy of your most recent federal tax return, bank statements, and a recent pay stub (if applicable). This will help us determine if you qualify for the program. Federal Poverty Guidelines are used to determine eligibility.
If your family gross income is between 300 and 500% of the federal poverty level (FPL), you could be eligible for a discounted rate if you are a New Jersey resident and are uninsured. This applies to dates of service beginning February 4, 2009. Click here for the Uninsured Application.
Cosmetic Procedures / Rates for Non-Covered Services
We offer flat package rates for certain procedures that are not covered by insurance. Please call Patient Financial Services at 201-291-6080 for more information.