About the Sliding Fee Scale
Healthcare Network uses a Sliding Fee Scale based on proof of income and individual patient’s ability to pay. We can assist you in applying for Medicaid benefits and reassign PCP’s. We also accept payment from third-party payers such as Commercial Insurance, Health Maintenance Organizations (HMOs) with authorization, Medicare and Medicaid.
How Does Healthcare Network Offer a Discount on Services?
Healthcare Network is a Federally Qualified Health Center. We offer a Sliding Fee Scale that reduces fees on services for qualified patients. We are able to do this because we are partially supported by federal grants. This support does not cover the full cost of all the services we provide, therefore, patient payments are vital to our ability to provide the care you need at a discounted rate.
What is a Sliding Fee SCALE?
Healthcare Network offers a program that reduces fees charged to uninsured patients based on their income and family size. We base patient eligibility for this program on percentages of “Poverty Levels” determined annually by the federal government. Fees are determined either by a minimum fee or a percentage of the full charges. Insured patients may benefit from this plan as non-covered services may also be subject to a fee reduction.
How Do I Qualify?
Like every program, Healthcare Network’s Sliding Fee Scale has requirements. The federal government requires that we obtain specific information from our patients prior to determining eligibility and establishing a sliding fee level. Determinations are not made until the required documentation has been provided.
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ENGLISH, SPANISH & HAITIAN CREOLE BROCHURE
This is what you need to bring prior to or on the day of your appointment. In order for you to qualify
for our Sliding Fee Scale, you must fill out an application and provide one of the documents below.
-
Pay Stubs
(most recent 4 weeks of income) or, -
Most recent Income Tax Return
(attach Schedule C if self-employed) –Expires 04/15 of the following year or, -
Workers Compensation
(most recent four weeks of income) or,
-
Unemployment Compensation
(most recent 4 weeks of income) or, -
Disability or SSI Benefits letter
(permanent or temporary) or, -
Social Security Income
(proof of monthly deposit or annual letter) or, - Documents from local, state or federal agency or,
-
Completed Employment Verification
(for cash paid household members) or, - Notarized letter of support from family member (when none of the above is available) or a notarized letter stating you have no income or,
- Any type of documentation that serves as proof of income or financial status.
Determinations are not made until
the required documentation has been provided.
