An application made by a hospital on behalf of a medically indigent person pursuant to § 28-13-32.3 shall be submitted to the county auditor within one year of the discharge of the indigent. The application shall include: (1) The notice of hospitalization as provided in § 28-13-34.1 ; (2) The dates of hospitalization; (3) The final diagnosis; (4) The cost of hospital services; and (5) Any financial information in the possession of the hospital concerning the patient or the responsible party, including the availability of insurance coverage. The county may not require the hospital to provide more information concerning such a medically indigent person than is contained in the application provided for in this section and the release of information provided for in § 28-13-34.2 .
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