Covenant Health is an innovative, Catholic regional delivery network and a leader in values based, not-for-profit health and elder care. We sponsor hospitals, nursing homes, assisted living residences and other health and elder care organizations throughout New England.
LOCATIONS

Online Payment Center

St. Mary's Patient Rep/Billing Office at 207-777-8208

Please choose a service:

COMMUNITY CLINICAL SERVICES - APPLICATION FOR DISCOUNTED FEES

CLICK HERE to Download the CCS Financial Application Form (Pdf)

To be assessed for a sliding-fee discount, applicants must provide the Federally Qualified Health Center (FQHC) Office with requested information as indicated on the application. The completed application may be mailed or dropped off to:

Community Clinical Services FQHC
Patient Rep/Billing Office
PO Box 291
Lewiston, ME 04243-9971

You may call St. Mary's Patient Rep/Billing Office at 207-777-8208 for questions or assistance in filling out the form.

ST. MARY'S REGIONAL MEDICAL CENTER - APPLICATION FOR FREE CARE

CLICK HERE to Download the St. Mary's Financial Application Form (Pdf)

CLICK HERE for 2017 Free Care Guidelines (Pdf)

To be assessed for Free Care, applicants must provide the Patient Rep/Billing Office with requested information as indicated on the application. The completed application may be:

mailed to:

St. Mary's Regional Medical Center
Patient Rep/Billing Office
PO Box 291
Lewiston, ME 04243-9971

Phone 207-777-8208 

faxed to:

207-777-8224

dropped off at:

St. Mary's Regional Medical Center

Patient Rep/Billing Office

93 Campus Avenue, Lewiston, ME 04243.

You may call St. Mary's Patient Rep/Billing Office at 207-777-8208 for questions or assistance in filling out the form.

All applications must be completed, signed, and returned with proof of income. Any incomplete applications will be returned.

St. Mary's Health System • 93 Campus Avenue • Lewiston, ME 04240