Virtual visits now available. You may be able to schedule a virtual visit with your provider. For more information, call your doctor’s office.
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 877-727-9190

Pay Online Now

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 877-727-9190 for questions or assistance in filling out the form.

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

For an application for Free Care and a Summary of Coverage, click here

View 2021 Free Care Guidelines

Read the Full Financial Assistance Policy

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 877-727-9190

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 877-727-9190 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