Sliding Scale Fees

Effective Date: 09/01/2020 Area: Client Services Version & Revision Dates: 1 Approval: CEO, Felicia Blakley Approval Date: 10/17/2025

POLICY

Primo Center is committed to providing quality services to the individuals and families we serve regardless of their ability to pay. Sliding fee scale discounts apply to all directly provided services according to family size and income. Primo Center maintains a standard procedure for qualifying clients for sliding fee scale discounts for services provided. Sliding fee scale discounts are available to clients with all incomes at or below 200% of the federal poverty guidelines.

PURPOSE

To reduce and/or eliminate financial barriers to care for medically underserved populations.

PROCEDURES

  1. Primo Center completes an intake package for all of its clients and assesses if they have healthcare coverage. A majority of Primo Center’s clients are homeless, and the fee agreement is $0 for services. The fee agreement is signed by all of its homeless clients. For those clients that have health insurance, the information is documented in the client’s file at the time of registration. If the patient has Medicaid or Medicare, their eligibility will be verified prior to service.
  2. For clients with income, enrollment staff will inform them that they have the option to apply for a sliding fee scale discount. Primo Center’s website will also communicate the availability of a sliding fee scale discount. The sliding fee scale can also apply for co-payments, deductibles, and coinsurance. In order to qualify, the client must share family and gross income information. A family consists of those members of the household supported by the reported income, typically the individuals reported on the federal tax return. If the client agrees to begin the qualification process, staff asks the client to complete the sliding fee scale application and provide any of the following documentation of gross income for all household members:
    • Federal income tax return
    • Two current pay stubs
    • Unemployment benefit award letter
    • Letter from employer on letterhead
    • Award or benefit letter
    • Affiliated agency income verification documentation that meets above requirements
    • Self-attestation of income statement
    Clients that do not wish to apply for a sliding fee scale discount will be asked to attest to income and household size to be compliant with Primo Center’s sliding scale fees. Clients that refuse to be assessed will be billed full charges for their services. Note: A client is still eligible for a sliding fee if their residency status is unknown or they are disqualified from government benefits.
  3. The client is eligible for sliding fee discounts when all documentation is received and income criteria for discounts are met. Documentation is copied and filed and/or scanned in the patient’s medical record.
  4. Using the attached sliding fee scale, determine the specific amount of discount for which the client is eligible. The sliding fee scale will be reviewed and/or updated annually when the federal poverty guidelines are published in the federal register and Primo Center’s board of directors approves any changes.
  5. Update the client’s chart to reflect eligibility for sliding fee scale discounts and the level of discount for which the client has qualified.
  6. The discount is applied to services provided by Primo Center, including dates of service prior to the determination.

SCOPE

All Programs