Translated Charity Care Forms

Thank you for choosing Overlake Medical Center as your provider of healthcare services. We want your experience with us to be as pleasant as possible, from the time you register for services to the time your patient account is resolved. We recognize financial difficulties may accompany the receipt of health care services and want you to know we offer programs to assist you. We employ financial counselors who are happy to answer any questions you may have about our programs and can help you apply for the best program for you.
 

Prompt Pay Discount Programs

 This program is available for services where there is no insurance coverage. This program is also applicable to patients who are eligible under a medical insurance program, but have no insurance coverage because they have maximized their benefit limits.

• Patient is granted a 50% discount from the total hospital account charges by paying the full balance to Overlake Medical Center within 30 days of the date of the first billing statement.*
• Patient is granted a 30% discount from the total clinic account charges by paying the full balance to Overlake Medical Clinics within 30 days of the date of the first billing statement.*

* Estimates include the 50% discount for hospital charges/30% discount for the clinic charges. Please contact a financial counselor at 425.688.5655 or call 425.688.5299 to make arrangements to receive the discount.
 
Below are links to financial assistance and charity care forms that have been translated into their respective languages.
 

Amharic

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Arabic

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Chinese (Simplified Chinese)

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

English

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

European Portuguese

• Financial assistance information.
• Charity care policy..
• Financial assistance/charity care application.
• Self-pay policy.

Farsi

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

French

• Financial assistance information.
• Charity care policy
• Financial assistance/charity care application.
• Self-pay policy.

German

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Gujarati

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Hebrew

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Hindi

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Italian

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Japanese

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Korean

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Malayalam

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Oromo

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Polish

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Punjabi

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Romanian

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Russian

• Financial assistance information
• Charity care policy
• Financial assistance/charity care application
• Self-pay policy

Spanish

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Swedish

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Tagalog

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Tamil

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Telugu

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Turkish

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Ukrainian

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Urdu

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.

Vietnamese

• Financial assistance information.
• Charity care policy.
• Financial assistance/charity care application.
• Self-pay policy.