Sliding Fee Program

 

About Slide

Our sliding fee discount schedule is based on the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 41 U.S.C 9902(2), with approval from the Jordan Valley Community Health Center Board of Directors. The sliding fee discount schedule is updated annually, based on changes to the poverty guidelines, by the Finance Manager with approval from the Jordan Valley Community Health Center Board of Directors.

In order to qualify for the sliding fee program, patients must complete the sliding fee program application paperwork and provide the appropriate proof of income. Patients cannot be seen on the sliding fee program until they have completed thier sliding fee paperwork and  have been enrolled by a Jordan Valley Slide Coordinator. Enrollment must be renewed annually.

Important Information

  1. Proof of income includes all persons living in the household.

  2. Any household members determined to potentially qualify for Medicaid coverage are strongly encouraged to apply for Medicaid. Our staff is available to assist you with this process.

  3. If the necessary paperwork is not provided, the appointment can either be rescheduled or standard charges will apply

  4. The following documentation is required at the time of appointment:

    • Proof of Income​

    • Photo ID

Sources of Income

The following are approved ways to verify your household income:

  • Wages/Salaries/Tips

  • Unemployment compensation

  • Workmen's compensation

  • Welfare benefits

  • Social Security

  • Supplemental Security Income

  • Pensions

  • Veteran's benefits

  • Survivor's benefits

  • Earnings from need-based employment programs

  • Regular contributions from persons not living in household

*Any other income not included in the list above.

Proof of Income

Proof of income is required to qualify for the program and includes the following:

  • The most recent 1 - 3 paycheck stubs

  • Employer earning statement

  • Federal or State Award Letter

  • Benefit check

  • Statement of Benefits

  • College award letter with total amount of grants or loans received

Program Discounting

Once approved for the sliding fee program, all qualifying charges from a medical visit above the copay amount will receive a sliding fee discount.

Medical visits include all services provided on-site at Jordan Valley Community Health Center with the exception of tests and procedures not routinely performed or deemed medically necessary by Jordan Valley providers. Limited labs, x-rays, and other services will be included in the slide fee co-pay. Please see a member of our staff for assistance with pricing for services not included in the visit co-pay. 

Each appointment with a provider, regardless of the frequency or reason, will be subject to the sliding fee co-pay and due at the time of service. 

Program Pricing 

Four Tiered Pricing Based on Slide Level

All payments are due at the time of service. Discounts may be available regardless of insured status.  

*Adults (age 19 and older) | **Children (age 18 and younger)

Medical (Excluding Preventative)

$45 for adults* at 176% - 200% of the federal poverty guidelines.

$40 for adults* at 151% - 175% of the federal poverty guidelines.

$35 for adults* at 101% - 150% of the federal poverty guidelines.

$25 for adults* at or below 100% of the federal poverty guidelines.

$10 - $20 for children**

Well Child Visit

No co-pay required - Usual slide fee applies for visits other than routine physicals and immunizations

Mental Health

$10 - $20 for adults* and children**

Psychiatry/Specialist/Preventative

$55 - $75 for adults* and children**

Dental

Patient pays fixed fee at or below 100% of the federal poverty guidelines; 60% - 80% of charges above 100% of the federal poverty guidelines