We are Here for You

We understand unexpected healthcare costs are probably not in your household budget. Eligible patients may qualify for discounted emergent or medically-necessary hospital care, based on the Citizens Medical Center Financial Assistance Policy.

For questions regarding Financial Assistance please contact:

Citizens Medical Center

Phone: (785) 460-4881 or Email: lsalmans@cmciks.com

The Financial Assistance Policy exists to provide eligible patients with discounted emergent or medically necessary hospital care. Patients seeking financial assistance must apply for the program, which is summarized below:


How to Apply

  • Obtain and submit a completed Financial Assistance Questionnaire. Forms are available at the front desk or at the Patient Financial Advisor office located at 100 E. College Drive, Colby, KS 67701. You may request one by calling (785) 460-4881.
  • Send a request for an application by mail to: Citizens Medical Center, 100 E. College Drive, Colby, KS 67701. You may also download the Financial Assistance Application, policy (politica) and addendum.
  • Eligibility determinations are made by a team consisting of the Patient Financial Advisor, Billing Office Manager and Chief Financial Officer. Candidates are evaluated based on their income levels and assets.

Financial Assistance

Citizens Health recognizes that some patients may not have insurance or have insufficient insurance to cover their full cost for their care and treatment. Citizens Health further recognizes some individuals may not have the ability to pay for the remaining balance after insurance has paid. Therefore, a Charity Care program has been established whereby a patient and/or guarantor may apply for a reduction in the amount of their patient account. To qualify for a Financial Assistance discount, patients are required to fill out an application and provide supporting income documentation,

Download English Application

Download Spanish Application


Determination of Financial Assistance Eligibility

  • Generally, patients are eligible for financial assistance based on their income level and assets. Patients with a family income of 100% of the Federal Poverty Level or less may be eligible for a discount of 100%.
  • Patients with a family income of over 100% of the Federal Poverty Level may be eligible for a discount of either 50% or 30%.
  • Eligible patients will not be charged more for emergency or other medically necessary care than Amounts Generally Billed (AGB) to those patients who have insurance.
  • Elective care is not covered by financial assistance and is the responsibility of the patient at 100% of charges.

Financial Assistance Brochure


Participating Physicians

Adam Horinek, PA-C

Alexandra Keller, PA-C

Amanda Reid, PA-C

Andrea Kittrell, MD

Angelia Relph, CRNA

Brady Gilson, PA-C

Brenda M. Kopriva, MD

Brewster A. Kellogg, DO

Brian Unruh, PA-C

Christopher Friedly, CRNA

Courtney McCarty, Dietitian

Daniel P. Kuhlman, MD

Darren Matchell, DO

Dereck Totten, MD

Jennifer Haag, PA-C

Jenny Niblock, APRN

Jerome Molstad, PA-C

John Evans, CRNA

Kamau Gitau, CRNA

Kara S. Kuhlman, MD

Kelly B. Gabel, DO

Kristina Benson, APRN

Kysha Nichols-Totten,MD

Luetta Flanagin, APRN

Philip Fitzpatrick, MD

Rachel Schiferl, Dietitian

Regina Taylor, PA-C

Richard Kilgore, CRNA

Robert Erwin, CRNA

Robert Hieger, APRN

Ryan Borne, MD

Sarah M. Gabel, DO

Tricia Carney, APRN


Our Standard Charges

In fiscal year 2019, Hospital Inpatient Prospective Payment System final rule, the Center for Medicaid and Medicare Services (CMS) requires hospitals to provide a list of standard charges via the internet [CMS-1694-F Section X). CMS updated their guidelines to require hospitals to make available a list of their current standard charges via the internet in a machine-readable format and to update this information at least annually, or more often as appropriate. This could come in the form of the chargemaster itself or another form of the hospital’s choice, as long as the information is in machine-readable format.” (42 CFR Pars 412, 413, 424, and 495 [CMS-1694-F]).

Please note the following:

  • Charges are subject to change at any time
  • The list of charges does not constitute a contract.
  • While this document outlines standard base charges, these are not necessarily charges a patient will see.
  • Every patient is unique and actual patient payment is highly dependent upon a combination of factors.
  • Even for similar procedures at the same facility, what a patient actually pays may differ based on their insurance plan and other factors.
  • During your visit, you may have other charges related to physician services that will be billed separately by those service providers. Some of those services could include physician services, anesthesia, pathology, and laboratory.
  • Cost is only one factor consumers should review when making healthcare decisions. Outcomes, quality/safety data and experiences should also be considered.

Uninsured or underinsured patients may qualify for charity care or financial assistance.  For more information on financial assistance, call Financial Services at (785) 460-4881.