Payment Plan Options
PAYMENT OPTIONS: Payment in full is due upon receiving your billing statement. We accept
payment by cash, personal check, MasterCard, or Visa. If you are unable to pay the total
amount due, a payment plan can be set up with Gundersen St. Joseph’s Patient Financial
Services. Payments must be in equal amounts ($50 minimum) and set up to be automatically
deducted. These automatic payments can be made from a checking account, savings account or
credit card.
Payment Plan Options
Amount Due
Payment Plan Terms
$0 -$1,500
12 months
$1501 - $5000
24 months
$5001 and over
36 months
Payment plan agreements apply to the balance due at the time the payment plan is setup. If
additional charges are incurred the payment plan will be reviewed to see if it needs to be
amended to meet the payment options. The first payment is due at the time the payment plan
is set up.
Failure to pay the required amount as listed in the executed agreement will void the payment
agreement.
If you need additional help paying your bill, or have questions, please contact the Patient
Financial Services Department at 608-489-8198 to discuss qualification for our Financial
Assistance Program.
400 Water Ave., PO Box 527
Hillsboro, WI 54634
Ph: 608-489-8198