If you are an uninsured person with no public or private source of payment for medical services, Cumberland Medical Center will provide, at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling (931) 484-9511 or (931) 459-7281, Monday through Friday between the hours of 8:00 a.m. and 4:30 p.m.
- Before any financial assistance is granted, you must have already exhausted all other sources of payment including insurance, public assistance, litigation, or third-party liability.
- Family income, in relation to federal poverty guidelines
- Assets (e.g. home, bank account, and stocks)
- Any additional financial hardship
- You must be receiving non-elective, medically necessary care, and you must live within the service area of Cumberland Medical Center.
How to Apply for Financial Assistance
- Call financial counseling services at (931) 459-7281. A financial counselor will advise you and investigate other sources that might provide financial assistance.
- Complete a financial assistance application and submit it along with the following.
- Complete copy of your most recent Federal Income Tax Return and all schedules. Include copies of last year's W-2 forms.
- Copies of the three most recent, paycheck stubs or a statement from the employer.
- Copies of three most recent bank statements (e.g., savings, checking, money market, IRA, 401K, etc.)
- Copies of unemployment, disability compensation benefits statements
- Copies of social security or pension benefits income
- Copy of food stamp allocation
- Copies of government assistance notices (including Department of Health & Human Services)
- Copy of TennCare denial letter
Note: If you do not have all of these documents contact one of our financial counselors. All correspondence to the financial counselors should be marked "Attention Financial Counseling".
How to Obtain a Financial Assistance Application
There are several ways by which you can obtain an application for financial assistance.
- Print the application off our Web site.
The financial assistance application has been converted to Portable Document Format (PDF). To view the PDF file, you will need Adobe Acrobat Reader installed on your computer. If you do not have Adobe Reader cick the icon below and download a free copy.
Click Here to Download Adobe Reader
Click Here to Download the Financial Assistance Application
- Pick-up an application at any of the following locations:
Patient Access Outpatient Imaging Center
Patient Access First Floor CMC
Patient Access at CMC Fairfield Glade
Business Office Third Floor CMC facing Hwy 70
- Contact us by calling (931) 459-7281 to request an application.
Cumberland Medical Center will not discriminate in the determination of financial assistance eligibility on the basis of race, color, ethnic origin, sexual orientation, marital status, creed, age, sex or disability.
Contact Phone Number: (931) 459-7281