Financial Assistance
We are committed to supporting your journey towards better mental health and well‑being. On this page, you’ll find the essential documents you need to manage your care with us.
Download the application
Available in English, Spanish, S’gaw Karen, and Burmese.
Gather your documents
Proof of income, ID, and any insurance information.
Submit by email or mail
To accountsreceivable@rvbh.com or our PO box below.
We respond within 7 days
A billing specialist will confirm receipt and next steps.
How to Apply Step-by-step: what to submit and where to send it.
- Download and complete the Financial Assistance application.
- Attach proof of income for all household members.
- Submit by email or U.S. mail using the details on the right.
- A billing specialist will confirm receipt within 7 business days.
Required Documents What to include with your application.
- Recent pay stubs or proof of income (last 30 days)
- Most recent federal tax return
- Bank statement (last 30 days)
- Government-issued ID
- Insurance card(s), if applicable
Missing something? Call our billing team, and we’ll walk you through it.
Billing & Bank Information Pay a bill, request an itemized statement, or set up a payment plan.
You can pay online, by phone, or by mail. If your balance is more than you can pay right now, we’ll work with you on a no-interest payment plan.
Financial Assistance Policy The full policy document (required by IRS 501(r)).
Our Financial Assistance Policy describes eligibility, the application process, how we calculate amounts owed, and actions we may take in the event of non-payment. It applies to all clients who receive emergency or medically necessary care at RVBH.
Plain Language Version A short summary of the policy in everyday language.
If you can’t afford your care at RiverValley, you may qualify for free or discounted services. Here’s the short version:
- Anyone can apply — you don’t need insurance.
- Assistance is based on your household income and family size.
- We won’t refuse emergency care while your application is reviewed.
- There is no cost to apply.
Sliding Fee Scale Services priced on your ability to pay, based on household income and size.
We don’t want cost to keep anyone from getting the care they need. Our sliding fee scale adjusts what you pay for services based on your household income and the number of people in your home. If you qualify, your fees are discounted — in some cases significantly — so you can continue treatment regardless of insurance status.
Who qualifies:
- Uninsured or underinsured individuals and families
- Households whose income falls at or below the current federal poverty guidelines
- Anyone experiencing a change in circumstances that makes the standard fee unaffordable
How to apply:
Complete the Financial Assistance application (linked above) and submit it with proof of income for everyone in your household. See Required documents for the full list. Once we review your application, we’ll notify you of your fee tier — usually within seven business days.
RiverValley Behavioral Health is proud to be the first thought
RiverValley Behavioral Health is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), demonstrating that our organization is committed to providing the best possible quality of care for our clients and communities.
