All patients seeking treatment with Journey to Wellness Counseling will be served regardless of ability to pay. Journey to Wellness bases program eligibility on a person’s ability to pay and does not discriminate based on an individual’s race, sex, national origin, color, disability, religion, age, gender identity, or
sexual orientation.
The Federal Poverty Guidelines are used in creating and annually updating the sliding fee schedule (SFS) to determine eligibility.
Requests for discounted services may be made by patients, family members, social services staff, or others who are aware of existing financial hardship. The Sliding Fee Discount Program will only be made available for clinic visits, and does not apply to those services purchased from outside, including
laboratory testing, drugs, imaging, and other such services.
Completion of Application
The patient/responsible party must complete the Sliding Fee Discount Program application in its entirety. Staff is available, as needed, to assist patient/responsible party with applications. By signing the Sliding Fee Discount Program application, persons are confirming their income to Journey to
Wellness Counseling as disclosed on the application form.
Eligibility
Discounts will be based on income and family size only.
a. Family is defined as: a group of 2 people or more (one of whom is the householder) related by
birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family. Journey to Wellness will also accept non-related household members when calculating family size
b. Income includes: gross wages; salaries; tips; income from business and self-employment; unemployment compensation; Social Security; workers’ compensation; Supplemental Security Income; veterans’ payments; survivor benefits; pension or retirement income; interest; dividends; royalties; income from rental properties, estates and trusts; alimony; child support;
assistance from outside the household; and other miscellaneous sources.
Income Verification
Applicants may provide one of the following: prior year W-2, two most recent pay stubs, letter from employer, or Form 4506-T (if W-2 not filed). Self-employed individuals will be required to submit detail of the most recent 3 months of income and expenses for the business. Adequate information must be
made available to determine eligibility for the program. Self-declaration of income may be used. Patients who are unable to provide written verification may provide a signed statement of income.
Discounts
Those with incomes at or below 100% of poverty will receive a full 100% discount for healthcare services. Those with incomes above 100% poverty, but at or below 200% of poverty, will be charged a nominal fee according to the attached sliding fee schedule. The sliding fee schedule will be updated during the first quarter of every calendar year with latest FPL guidelines.
Nominal Fee
Patients with incomes above 100% of poverty, but at or below 200% poverty, will be charged a nominal fee according to the attached sliding fee schedule and based on their family size and income. However, patients will not be denied services due to an inability to pay. The nominal fee is not a threshold for
receiving care and thus, is not a minimum fee or co-payment.
Waiving of charges
In certain situations, patients may not be able to pay the nominal or discount fee. Waiving of charges must be approved by Journey to Wellness’s designated official. Any waiving of charges is documented in the patient’s file along with an explanation.
Applicant notification
The Sliding Fee Discount Program determination will be provided to the applicant(s) in writing and will include the percentage of Sliding Fee Discount Program write off or, if applicable, the reason for denial. If the application is approved for a less than 100% discount or denied, Journey to Wellness will work
with the patient and/or responsible party to establish payment arrangements.
Sliding Fee Discount
Program applications cover outstanding patient balances for 6 months prior to application date and any balances incurred within 12 months after the approved date, unless their financial situation changes significantly. The applicant has the option to reapply after the 12 months have expired or anytime there has been a significant change in family income. When the applicant reapplies, the look back period will be the lesser of 6 months or the expiration of their last Sliding Fee Discount Program application.
Refusal to pay
If a patient verbally expresses an unwillingness to pay or vacates the premises without paying for services, the patient will be contacted in writing regarding their payment obligations. If the patient is not on the sliding fee schedule, a copy of the Sliding Fee Discount Program application will be sent with the notice. If the patient does not make effort to pay or fails to respond within 60 days, this constitutes refusal to pay. At this point in time, Journey to Wellness can explore options not limited to, but including offering the patient a payment plan, waiving of charges, or referring the patient to collections.