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Sliding Fee Application It is the policy of Intermountain to provide affordable and quality services. The Sliding Fee Discount Program is designed to help those who are uninsured or under insured
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How to fill out sliding fee applicationintermountain
How to fill out sliding fee applicationintermountain
01
Go to the Intermountain website or visit a local clinic to obtain a sliding fee application form.
02
Fill out the application form completely and accurately with your personal information.
03
Gather any required documentation such as proof of income or tax returns.
04
Submit the completed application and documentation to the designated Intermountain office or clinic.
05
Wait for the application to be processed and receive notification of your sliding fee eligibility.
Who needs sliding fee applicationintermountain?
01
Individuals or families who have limited income and financial resources may need to fill out the sliding fee application at Intermountain to qualify for reduced healthcare costs.
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What is sliding fee applicationintermountain?
The sliding fee applicationintermountain is a form used to apply for reduced fees for healthcare services based on household income.
Who is required to file sliding fee applicationintermountain?
Individuals with low income who are seeking healthcare services at the Intermountain Healthcare facilities may be required to file a sliding fee application.
How to fill out sliding fee applicationintermountain?
To fill out the sliding fee applicationintermountain, individuals need to provide information about their household size, income, and expenses. The form can be obtained from the Intermountain Healthcare facilities or website.
What is the purpose of sliding fee applicationintermountain?
The purpose of the sliding fee applicationintermountain is to ensure that individuals with low income have access to affordable healthcare services provided by Intermountain Healthcare.
What information must be reported on sliding fee applicationintermountain?
Information such as household size, income, expenses, and supporting documentation of income must be reported on the sliding fee applicationintermountain.
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