Sliding Scale Discount Policy

PCC is here to serve people who may not have normal access to health care, either because of distance or economics. We are glad to be able to help our neighbors, and we treat all patients alike, regardless of their class, race, age, gender or handicapped status.

1. No one is denied medical services because of lack of ability to pay.

2. Family income is usually considered as a unit; a family is a group of related or unrelated individuals occupying the same living quarters and sharing expenses. An adult household member may be excluded under certain circumstances, in which case they are not counted toward family size and their income is excluded. Any adult being counted must include their income. (The staff member determining family size may consult with the Office Manager or Administrator before deciding.)
3. Dependent children living at home (as defined by the IRS) are counted as family members even if they have an after-school job. The income from that type of employment is not included in household revenue.
4. Gross income from the family is considered; unusual living expenses, such as the costs of a chronic medical condition, may be considered. The cost of health insurance, if any, is deducted from gross income. Proof of cost must be shown.

5. Proof of income is required; this may be paystubs or W-2s for each adult wage earner or copies of as many 1040 forms as appropriate. The Discount Tables are used to calculate the final income amount used.
6. Income levels are reviewed annually. The sliding scale file is reviewed monthly so that families needing to be reviewed can be called.
7. The staff member obtains copies of health insurance cards and income documents.
8. The family is assigned a rate from the sliding scale table. The rate depends upon family size and income as a percent of the Federal Poverty Level. The chart is updated annually.
9. Pharmacy charges are not covered; however, there are programs to help with these costs, for which some families may be eligible. If a family qualifies for company-sponsored indigent meds or labs, that resource is used.
10. When a patient calls for an appointment, the receptionist looks up their payment category. If they do not have insurance, the rate set for the family acts as a co-pay; it is expected before the patient leaves the facility.
11. If the visit is covered by insurance, the carrier is billed. The patient is responsible for their co-pay or the coinsurance, whichever is less. If possible, this amount is determined at the time of the visit and the amount is collected at that time.
12. Collection policies for families on sliding scale are the same for the amount they owe as for any other patients.
13. The Office Manager is responsible for the supervision of the sliding scale system.

8-04-00