FINANCIAL RESPONSIBILITY
We are committed to providing you and your family the best possible care, and are pleased to discuss our professional fees with you at any time. Your clear understanding of our financial policy is important to our professional relationship. Please ask if you have any questions about our fees, financial policy or responsibility.
We are not a free clinic. Patients without insurance are eligible to apply for a health care discount based on current Federal Poverty Guidelines. Health care discounts are offered on a sliding fee scale. The sliding fee scale takes into account family size and income determined on the Federal Poverty Guidelines. Nominal fees charged for essential services will be collected. Proof of household income (POI) is required to receive the sliding fee.
Payment in full is due at the time of service. In the case of a minor, the patient’s accompanying adult, parent, or guardian is responsible for payment at the time of service.
INSURANCE
We accept most insurance plans. Patients are responsible to check with their insurance company on any restrictions.
All insurance co-pays are due at the time of service.
We will submit insurance claims on your behalf; however, we will not become involved in in disputes between you and your insurance company regarding deductibles, co-insurance, covered charges, secondary insurance, etc., other than to support factual information necessary. You are responsible for the payment of your account.
Patients without insurance are eligible for our Sliding Fee Scale for services rendered at the time of their appointment. In order for a patient to use our Sliding Fee Scale they will need to provide Proof of Income (POI). If you do not have an income you must provide the household income of which you reside. Below are examples of approved POI documents for the sliding fee. (POI is updated annually):
- Three (3) current pay stubs
- IRS Tax Return of previous year
- Food Stamp Award Letter
- Social Security Award Letter
- Child Support Statement
- Unemployment Letter
We accept cash, checks, Visa, MasterCard and debit cards.
