Billing

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” (GFE) explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Sliding fee discount

All insured patients – regardless of nationality or immigration status — are charged on a sliding fee scale according to income and family size. Click here to view the sliding fee discount for Medical and Behavioral Health.

Sliding Fee Discount Program Policy and Procedure

Policy

Patients will never be denied services because of an inability to pay. Billing statements to patients will reflect this policy. In an effort to assist those unable to pay for medical care, CDCHC provides services based on a flat fee that is determined by Federal Poverty Guidelines, income, and family size.

Procedures

• If the patient does not have insurance or other medical coverage, they will be offered the opportunity to participate in our flat fee discount program.
• The sliding fee consideration is also available to clients who have insurance to reduce any cost not covered by insurance except the co-pay and deductible amounts.
• The number of individuals in the household and documented gross household income reported on the Patient Financial Agreement Form will determine the flat fee level.
• All patients are requested to pay a minimum of $20.00 for each medical visit.
• The sliding fee scale is revised annually by the CFO based on the published Federal Poverty Level guidelines. It is distributed to the finance department, the front desk and eligibility team staff.
• The following charges are not eligible for sliding fee discount: pharmacy, insurance co-payments, deductibles and managed care contracted co-payment amounts.
• Collections are done at the time of service for patients without coverage and for insurance co-pays. If the patient cannot pay his/her full portion at time of service, a partial payment will be accepted. Country Doctor Community Health Centers will ask a minimum $20.00 payment at each visit.
• Flat Fee discounts are assigned as appropriate.
• Patients making partial payments or no payments at the time of service will be billed. Patient who pay their flat fee at the time of service will receive a $5.00 discount.
• Patients will be mailed account statements every 28 days. Patients are expected to pay their balances when able. Statements will clearly indicate that services will never be denied due to inability to pay.
• Billing and collection efforts will be applied equally to all patients.
• After 90 days of charges becoming patient responsibility, the balance is subject to “bad debt” write off.
• When checks are returned because of “NSF” or “closed account”, the AP Clerk will notify the billing department who will reverse the payment. The patient will be notified and billed on the next statement.
• A note regarding the return is entered into the note section of the patient’s account in the Epic system.