Sliding Scale Policy

mchc_black_regular.png

In accordance with 330(e) funding requirements and National Health Service Corp requirements, MCHC offers its qualifying patients a sliding fee discount schedule (SFDS).  Qualification is based on the Federal Poverty Guidelines (FPG), published annually in the Federal Register.

Patients will be charged for MEDICAL, BEHAVIORAL and OPTOMETRY services, including ancillary services like lab and x-ray, in accordance with the following:

  100% or below Federal Poverty Guidelines-(0%) $25. per visit

     101%-125% of Federal Poverty Guidelines- (25%) $35. per visit

    126%-150% of Federal Poverty Guidelines-(50%) $50. per visit

     151%-200% of Federal Poverty Guidelines- (75%) $75. per visit

     ABOVE 200% of Federal Poverty Guidelines- 100% of charge per visit

 

PATIENT QUALIFICATIONS FOR SFDS

In order to qualify for the SFDS, patients must present proof of income to MCHC registration personnel.  Eligibility for discounts will be based solely on income and household/family size.  Patients will be granted a ONE visit exclusion from providing proof by providing self-attestation of income.  However, for any subsequent visit, without proof of income, the patient will be considered to fall within the “above 200% of the Federal Poverty Guidelines” and billed at 100% of the charge.  The SDFS will be valid for one (1) year from the date proof of income is provided.

Patients will not be required to apply for insurance and be turned down as a prerequisite for eligibility for the SFDS.

Insured patients who are eligible for SFDS will be charged no more than the amount they would have owed under the SFDS based upon their pay class, subject to any contractual or other legal restrictions.

 

PHARMACY

Patients qualifying for SFDS will receive discounts on prescriptions at the following rate:

 100%-or below Federal Poverty Guidelines- (0%) pay $5.

     101%-125% of Federal Poverty Guidelines -(25%) pay $10.

     126%-150% of Federal Poverty Guidelines- (50%) pay $15.

     151%-200% of Federal Poverty Guidelines- (75%) pay $20.

     ABOVE 200% of Federal Guidelines- pay full charge

OPTOMETRY

Optometry visits (examinations) will be treated under the Medical/Optometry/Behavioral Sliding Scale Guidelines.  Glasses will be eligible for an additional sliding scale charge based upon the same Federal Poverty Guidelines.  Patients will be offered a selection of standard frames and lenses at the following SFDS charge:

   100% or below Federal Poverty Guidelines-(0%) $25.

     101%-125% of Federal Poverty Guidelines-(25%) $35.

     126%-150% of Federal Poverty Guidelines-(50%) $50.

     151%-200% of Federal Poverty Guidelines-((75%) $75.

     ABOVE 200% of Federal Poverty Guidelines- pay full charge

(If the patient selects a premium frame or lens, the patient will be charged an additional cost).

 

NO SLIDING SCALE AVAILABLE FOR FOLLOWING SERVICES

The sliding scale discount is not applied to the following services which arise at the request of employers or parties, other than the patient:

     Workers’ compensation examinations

     DOL exams

     DOT exams

     CDL exams

     Pre-employment or other work-related physicals

     Drug screens-not medically necessary

     All non-medically necessary services

 

Patients will not be refused treatment due to their inability to pay.  Patients who are unable to pay their fees incurred for services or items received may apply for Budget Plan/Pay Agreement or speak with an MCHC representative about requesting a hardship determination to waive or reduce fees.  If a patient refuses to pay the balance of their bill, refuses to work with a financial counselor to assist them in the payment of their bill, is sent to collections by MCHC but nevertheless continues to refuse to make payment thereon without requesting a hardship waiver, or is denied a hardship waiver by MCHC, then MCHC reserves the right to start the dismissal process of the patient from its services, through consultation with patient’s provider and MCHC’s legal counsel.