Financial assistance is available to anyone without insurance coverage. The Providence Everett Healthcare Clinic provides a sliding scale based on the patient's annual family income and family size. For those who cannot afford the sliding scale fee, the Salvation Army or Volunteers of America offer vouchers for qualified patients. Patients applying for financial assistance will be required to bring:
• A recent pay stub with year-to-date earnings, or
• A letter from the person providing financial support if the patient is not self-supporting.
• Our fininacial assistance form. Download the form, fill it out and bring it with you to your first visit. Who is eligible for financial assistance?
If your family income is less that 250% of the federal poverty standards and you have no insurance coverage, you may be eligible for our Financial Assistance Program. For example, the 2007 Federal Poverty guideline (FPG) for a family of 3 is $17,170. If your gross family income is less than 250% of this FPG (or less than $42,925 for the same family of three) you may qualify to pay a reduced amount for services in our clinic. What does the Financial Assistance Program cover?
If you are approved for financial assistance, you will pay a reduced amount for the office exam and certain medical procedure charges. The expected payment percent is what is commonly referred to as a “sliding fee scale”. The discount will range between 10% and 75% of the charge for the office exam and procedures depending upon your gross family income, family size and family members who already have insurance coverage. You will still be expected to pay the full charge for immunizations, supplies, and medications provided in the clinic. How is the amount of financial assistance determined?
You must complete an application for financial assistance and provide certain proof of income. We ask for the last three months of income or last year’s tax return and any information you feel will help you prove your financial need. If the above is not something you can provide or you have other sources of income, please provide information otherwise; we have staff and volunteers to help with this process. This application should be completed before your first appointment. When do I have to pay for being seen?
We expect all patients to pay for the full cost of their service at the time of the visit. All patients receiving financial assistance are required to pay in full their portion of the reduced fee at the time of their visit. By minimizing our billing costs, we reduce our overhead. Reduced overhead enables us to provide financial assistance to those who qualify. What if I am unable to pay even the reduced amount payment for the visit?
In that case you will be referred to the emergency room for care. How will I know how much to pay?
The staff at the clinic will advise you. We will provide you with an estimate of the expected payment for your scheduled visit when you call for an appointment. At the conclusion of your visit you will be given the exact amount, which you are expected to pay at that time. What kind of payment is acceptable?
We will accept cash, checks, debit and credit cards. What if I am unable to pay my entire expected payment amount?
If the actual cost of the visit is greater than our estimate and you are unable to pay the additional amount, we will discuss payment options with you. Overdue accounts
We will send a statement for unpaid accounts when necessary. Statement balances are payable in the month received. If a second statement must be sent, then an additional billing charge of $16 will be added to the account. We will not schedule a return appointment with a patient unless the balance of the account is paid in full or special payment arrangements have been made. If you feel that your need for medical treatment is urgent, you may be seen in the Providence Everett Medical Center Emergency Department. You will be able to resume your primary care at the clinic as soon as your account is paid in full or special payment arrangements have been made.
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