How to Design a Sliding Fee Schedule for a Mental Health Clinic

A sliding fee scale offers discounted fees for office visits based on a patient's ability to pay. Sliding fee schedules can increase access to mental health care for people with limited income. Additionally, it is a requirement for participation in some government loan repayment programs such as the National Health Service Corps Scholar, according to the U.S. Department of Health & Human Services. Designing a sliding fee schedule takes planning and effort but will benefit patients who need it the most.

Instructions

• 1

  Establish fees based on Federal Poverty Guidelines. Patients below the poverty line may receive free services. Patients at the poverty line may be charged a nominal fee.

• 2

  Raise fees incrementally. For example, patients at 125 percent of poverty may receive up to a 75 percent discount. Patients at 150 percent of poverty may receive up to a 70 percent discount and so on. Patients making 200 percent of poverty may be charged full price or the fee may continue to be raised incrementally until the full price is reached.

• 3

  Decide on eligibility verification standards. You may require patients to fill out an application form and provide proof of income to be eligible for the reduced fees. Verification may be based on pay stubs or income tax returns. Additionally, participation in some government-based assistance programs may be cause to automatically qualify patients. Such programs may include free or reduced lunch programs, Social Security Disability or Temporary Assistance for Needy Families. Temporary qualification for the program may be given allowing a patient to bring verification on the next visit.

• 4

  Establish re-evaluation protocol. Annual or semiannual re-evaluation of income may be appropriate. Sliding fee scale policy should advise patients of the re-evaluation period and ask patients to notify the office if they have a change in income.

• 5

  Notify patients. The sliding fee scale policy should be posted in a conspicuous area in the office waiting room. Additionally, the office may also wish to notify patients by mail. All patients should be made aware of this change in office policy and be given the chance to apply. If your office has a website, you may wish to post your sliding fee scale, official policy and application form on the website for easy patient access.

• 6

  Keep records. Patient applications and financial information should be kept confidential and handled discreetly. Free or low-cost visits should be documented in the same way as full-priced visits.