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SLIDING FEE DISCOUNT INFORMATIONIt is the policy of Phoenix Preferred Care to provide essential services regardless of the clients ability to pay. PPC offers discounts based on family size and annual income.Please complete the following information and return to the Intake Coordinator to determine if you or members of your family are eligible for a discount. The discount will apply to all services received at this clinic, but not those services provided by other agencies. You must complete
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How to fill out sliding fee discount program

01
Gather necessary documents such as proof of income (pay stubs, tax returns, etc.).
02
Obtain the sliding fee discount application form from the healthcare provider or their website.
03
Fill out the personal information section, including name, address, and contact details.
04
Provide your household income information accurately.
05
Include the number of dependents in your household.
06
Sign and date the application form to certify that the information provided is true.
07
Submit the completed application along with the required documents to the designated office.

Who needs sliding fee discount program?

01
Individuals or families with low or fluctuating income who cannot afford healthcare costs.
02
Patients seeking financial assistance for medical services or treatments.
03
Uninsured individuals or those with limited insurance coverage.

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The sliding fee discount program is a pricing structure that adjusts the cost of services based on a patient's ability to pay, typically used in healthcare settings to assist low-income individuals.
Healthcare providers, particularly those that receive federal funding or are part of a federal program, are required to file a sliding fee discount program to offer financial assistance to eligible patients.
To fill out a sliding fee discount program, individuals must provide personal financial information, including income, family size, and proof of income, typically on a designated application form provided by the healthcare provider.
The purpose of the sliding fee discount program is to ensure that healthcare services are accessible to all individuals, regardless of their financial situation, thereby reducing barriers to care.
Information that must be reported on a sliding fee discount program includes patient demographics, income level, family size, and the basis for the sliding scale used to determine discounts.
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