What is a Sliding Fee Scale Discount Program?

Hurtt Family Health Clinic welcomes all patients, regardless of their ability to pay, source of income, and insurance status. As an FQHC clinic, we are able to offer a wide selection of healthcare solutions through the Sliding Fee Scale Discount program.

Understanding sliding fee scale discount program

The sliding fee program allows Hurtt Family Health Clinic to help you care for you and your family’s health by reducing or “sliding” the cost of your healthcare. Our low cost medical clinics determine the discount based upon your family size and household income. The discounts to be eligible are updated annually according to the Federal Poverty Guidelines (FPG).

How to apply for the sliding fee scale discount program

Hurtt Family Health Clinic has streamlined procedures to help patients to conveniently apply for sliding fee discounts. The following are procedures for updating and applying Sliding Fee Discounts, in accordance with our sliding fee discount for all medical services policy:

  • Sliding Fee Application – to apply for sliding fee discount program (SFSD), you need to complete the sliding fee application form wherein you will indicate your income and household size. Aside from the application form, you also need to submit government issued identification card of the head of the household, proof of address, and proof of income.
  • Patients with Third Party Coverage – patients with insurance coverage are still eligible for the sliding fee discount.
  • Declining SFSD Eligibility Screening – patients who decline the SFSD eligibility assessment may still be reconsidered for the program any time once they agree to be screened for the program and submit the necessary documents.
  • Assigning and Updating Sliding Fee Status – all patients are required to update their income statement documentation every year.
  • Financial Assistance Options – our sliding fee program is designed to make healthcare more accessible, especially to underserved and uninsured patients in Orange County. We offer the following financial assistance options so cost will no longer hinder our patients from getting the healthcare they deserve.
  • Patient Special Needs Request (PSNR) Form – patients can submit a PSNR form if they are unable to pay the fee associated with their sliding fee schedule because of a temporary financial problem.
  • Payment Plan Form – this plan is used to help those who are unable to make full payment for their healthcare costs. Patients must submit a form explaining their financial situation and payment plan details.
  • Self-Declaration Form – this assistance program form is submitted by patients who want to be screened for eligibility for the Sliding Fee Discount.

The Sliding Fee Scale Discount program is a part of Hurtt Family Health Clinic’s effort in ensuring that patients in Orange County get the healthcare that they deserve regardless of their ability to pay. We offer this program in any of our fixed locations in Tustin, Santa Ana, and Anaheim.

To learn more about our discount programs, call us at (714)247-0300. You can also email info@hurttclinic.org.

Share

Your Donations can Help a Life

Donate now and help make a difference.

Make Donation