SLIDING FEE SCALE / DISCOUNTED PRICING

Revised August 21, 2024

 Blount Rural Health Center (Dental, Medical, and Behavioral Health) offers a Sliding Scale Fee/Discounted Pricing. Discounts are offered depending upon family income and size. A scale is used to calculate the discount and is updated each year based on Federal Poverty Guidelines.

To be eligible for the Sliding Fee Scale discounts, you must follow the policy set forth by Blount Rural Health Center. The policy requires the completion of an application and requires submitting truthful and accurate financial records, i.e. past years’ income tax return and/or past two months of paystubs, of all working individuals living in the home and a count of all people living in the home. (Please ask our front desk staff for a copy of the policy).

Anyone applying for the Sliding Fee Schedule will be required to apply for Kentucky Medicaid and submit documentation from the Department of Community Based Services as to whether you are approved or denied. Each year, you will be required to reapply for Kentucky Medicaid, submit financial records and complete a new application.

Due to the cost of various services provided by Blount Rural Health Center, although discounts are applied according to the adopted Sliding Fee Scale Schedule, discounts on medical, behavioral health, and dental will be figured differently.

Discounts are not applied to medications, dental lab fees or appliances. Medical lab fees are discounted. The discount is NOT applied to out of office referred care.

ESCALA DE TARIFAS ESCALONES/ PRECIO CON DESCUENTO

  Revisado el 21 de agosto de 2024

  El Centro de Salud Rural Blount (Dental, Médico y de Salud Conductual) ofrece una escala de tarifas con descuento. Los descuentos se aplican según los ingresos y el tamaño de la familia. Se utiliza una escala para calcular el descuento, que se actualiza anualmente según las Pautas Federales de Pobreza.

Para optar a los descuentos de la Escala de Tarifas Escalone, debe seguir la política del Centro de Salud Rural Blount. Esta política requiere completar una solicitud y presentar registros financieros veraces y precisos (por ejemplo, la declaración de impuestos de los últimos años o los últimos dos meses de recibos de sueldo) de todas las personas que trabajan y viven en el hogar, así como un recuento de todas las personas que viven en él. (Solicite una copia de la política a nuestro personal de recepción).

Cualquier persona que solicite la Escala de Tarifas Escalone deberá solicitar Medicaid de Kentucky y presentar la documentación del Departamento de Servicios Comunitarios que indique si su solicitud fue aprobada o denegada. Cada año, deberá volver a solicitar Medicaid de Kentucky, presentar sus registros financieros y completar una nueva solicitud.

Debido al costo de los diversos servicios que ofrece el Centro de Salud Rural Blount, si bien los descuentos se aplican según la Escala Móvil de Tarifas, los descuentos en servicios médicos, de salud mental y dentales se calcularán de forma diferente.

Los descuentos no se aplican a medicamentos, honorarios de laboratorio dental ni aparatos dentales. Los honorarios de laboratorio médico tienen descuento. El descuento NO se aplica a la atención derivada fuera del consultorio.

Blount Rural Health Center’s Sliding Fee Scale

Applicable to ALL Patients

Medical & Behavioral Health Services

Annual/ Yearly Income

 *For family units more than eight members, add $5,500 for each additional member ABOVE 200% - NO DISCOUNT

Payment 

To apply for the sliding fee option, patients should bring income documentation:

         *Three (3) consecutive current paycheck stubs                                                                                                                                     

         *Letter from the employer must be written on company letterhead

         *If self-employed - A Form 1040 tax return from the previous calendar year

         *If state income - letter from social worker, copy of award letter from the Social Security Administration, check stub or letter with details of pension benefits

The poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2).



Blount Rural Health Center’s Sliding Fee Scale

Applicable to ALL Patients

Dental Services

Annual / Yearly Income 

*For family units more than eight members, add $5,500 for each additional member ABOVE 200% - NO DISCOUNT

Payment 

To apply for the sliding fee option, patients should bring income documentation:

         *Three (3) current paycheck stubs                                                                                                                                                             

         *Letter from the employer must be written on company letterhead

         *If self-employed - A Form 1040 tax return from the previous calendar year

         *If state income - letter from social worker, copy of award letter from the Social Security Administration, check stub or letter with details of pension benefits

The poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2).

• All dental services are subject to the sliding fee scale. Please see list of Diagnostic & Preventative services, Basic Dental services and Other Dental services. For any service not listed, please ask a BRHC Dental employee for a discount.



Blount Rural Health Center’s Sliding Fee Scale – Applicable to ALL PATIENTS

Dental Services



All services are subject to the sliding fee scale. For any service not listed, please ask a BRHC Dental employee for a discounted price.