For Patients

Patient Accounts: 320-769-4393 or toll free at 888-769-2164

Like all businesses, Johnson Memorial Health Services must receive payment for bills so we can continue to provide the high quality services you’ve come to expect.

  • If you have a question about your bill, you may contact us via e-mail, or call the Patient Accounts office at 320-769-4393 or toll free at 888-769-2164.  If you choose email, we want to help protect your privacy online, so we ask that you not include billing information in your e-mail, especially, account numbers or social security numbers.
  • We welcome walk-in inquires Monday – Friday 7:30 a.m. to 5 p.m.  The Patient Accounts office is located right behind the front receptionist desk area.

We understand that not all of our patients can afford to pay their medical expenses in full at the time of service.  For this reason, we have developed several payment options that are listed below.

Payment Options

  1. Payment Arrangement– To request a monthly payment arrangement please click on the link below.  This option will allow you to make a monthly payment towards your outstanding bill with Johnson Memorial Health Services.  Your request for a payment arrangement can be denied if the monthly payment amount does not meet the requirements of the Johnson Memorial Health Services payment policy.  You will be asked to increase your monthly payment amount if you incur additional charges in the future.  If you have further questions, please contact the Patient Accounts office at 320-769-4393 x 2238.Payment Arrangement Request Form– Please complete the form and mail it to the address provided at the top of the form.
  1. Automatic Bank Withdrawal– To request a monthly automatic withdrawal from your checking or savings account to go towards your bill at Johnson Memorial Health Services, please fill out the form below.  Your request for an automatic withdrawal can be denied if the monthly payment amount does not meet the requirements of the Johnson Memorial Health Services payment policy.  You will be asked to increase your monthly payment amount if you incur additional charges in the future.  If you have further questions, please contact the Patient Accounts office at 320-769-4393 x 2238.Automatic Bank Withdrawal Request Form
    – Please complete the form and mail it to the address provided at the top of the form.
  1. Automatic Monthly Credit Card Payment – To request an automatic monthly credit card payment to go towards your bill at Johnson Memorial Health Services, please fill out the form below.  Your request for an automatic credit card payment can be denied if the monthly payment amount does not meet the requirements of the Johnson Memorial Health Services payment policy.  You will be asked to increase your monthly payment amount if you incur additional charges in the future.  If you have further questions, please contact the Patient Accounts office at 320-769-4393 x 2238.
    Automatic Monthly Credit Card Payment Request– Please complete the form and mail it to the address provided at the top of the form.
  1. Uninsured Discount – If you have no insurance, you may qualify for a 15% discount through this program.  Eligible patients or the responsible party need to complete an application for the uninsured discount.  Please click on the link below for the Uninsured Discount Application.  If Johnson Memorial Health Services determines a patient does have insurance, we will reverse the uninsured discount and bill the insurance for the full amount.  If you have further questions, please contact the Patient Accounts office at 320-769-4393 x 2238.Uninsured Discount Application– Please complete the form and mail it to the address provided at the top of the form.
  1. Charity Care Discount – The federal poverty income guidelines provide the initial framework to determine an individual’s ability to pay.  Factors include:  family size, income, and cost of providing shelter, food, utilities, etc. To qualify for the Charity Care Discount, you must first apply for Medical Assistance with your county.  If you qualify for Charity Care, the balance is either discounted or the entire balance is adjusted, based on the sliding fee schedule.  For example, in order to qualify:
    • 1 in household:  income and assets need to be <$20,800
    • 3 in household:  income and assets need to be <$35,200
    • 6 in household:  income and assets need to be <$56,800Please click on the link for the Charity Care Discount Application.  If you have further questions, please contact the Patient Accounts office at 320-769-4393 x 2238.

 Charity Care Discount Application

– Please complete the form and mail it to the address provided at the top of the form.