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Financial Assistance

If you have little or no health insurance to pay for the services you receive, we may be able to help.

Good Shepherd Rehabilitation provides financial assistance / charity care to patients based on income, assets and financial needs. If you are not eligible for charity care, we will arrange an interest-free payment plan to resolve any balances you may owe. 

For more information, including how to obtain a free physical copy of the Financial Assistance Application, please contact us:

Good Shepherd Rehabilitation
Billing Department
850 South 5th Street
Allentown, PA 18103
Phone: 610-776-3282
Email: revenuecycle@gsrh.org
Fax: 610-778-9272

Financial Assistance Policy

Financial Assistance Application

NOTE: All Good Shepherd Physician Group (employed) providers participate in Good Shepherd’s financial assistance program. Providers who are not employed by Good Shepherd do not participate in Good Shepherd’s financial assistance program.

Plain Language Summary

Good Shepherd uses the Federal Poverty Guidelines, which are updated yearly, to determine eligibility for Financial Assistance. Patients can complete the Financial Assistance Application and submit it to begin the review process as soon as possible. Determinations are based on a family’s current income and number of dependents. In addition, expenses and available financial resources are taken into consideration.

Financial assistance-eligible individuals cannot be charged more than the amounts generally billed for emergency or other medically necessary care. 

In order to determine your eligibility for charity care, you are required to provide copies of at least two of the following documents:

  • Latest federal tax return (if not available, state reason)
  • Most recent pay stub
  • Pension check
  • Bank statement
  • Social Security letter
  • Disability letter
  • Unemployment letter

Approval for Good Shepherd’s Financial Assistance / Charity Care is also contingent upon all other funding sources being pursued for payment of your medical services. This includes applying for Medicaid (Medical Assistance), which can be done through your County’s Assistance Office. After you apply for Medical Assistance benefits, please send a copy of their eligibility determination letter to our office (Good Shepherd Rehabilitation, Billing Department, 850 S. 5th Street, Allentown, PA 18103).

Good Shepherd will provide a final determination on an application within 14 days of receipt.

HHS Poverty Guidelines