Fee Scale FAQs

As a Community Health Center, Chase Brexton receives funding to help cover the cost of care for patients/clients who meet criteria based on income.

Fee Scale FAQs

What is a Sliding Fee Scale?
It's possible you may be eligible for a discount on what you owe for services if you qualify for our sliding fee scale. The sliding fee scale is used to determine your payment responsibility for services you receive. Eligibility is based on your gross household income and household size and is calculated  using federal guidelines.

How much will I have to pay?
Based on your income level, you will owe a minimum sliding fee rate.  This minimum sliding fee is due at time of services.  You will not receive a bill for any Medical or Behavioral Health services above the minimum fee.

There are also some services in the dental department which cannot be fee-scaled. These services and costs will be explained to you in a treatment plan prior to receiving the service.

How do I qualify?
Your total household income must fall within 200% of the Federal Poverty Guidelines to be eligible for the sliding fee scale. Sliding fee eligibility is based on the total family (yourself, spouse, and children under 18) size and combined gross income.

Can I use the Sliding Fee Scale instead of my insurance?
No. The funding Chase Brexton receives to assist patients is to be used as a last resort.  Chase Brexton must bill your insurance. If you have insurance Chase Brexton does not accept, you will still not be able to use the fee-scale.

How do I apply?
The Fee Scale Application (English / Spanish) must be completed along with the required proof of income and family size. The following documents are acceptable proof of income:

  • One month of consecutive pay stubs or letter of salary
  • 1040 Tax Forms
  • Unemployment letter
  • Social Security award letter
  • Support letter, also called 'Verification of No Income (English / Spanish),' for those with no income

Return the completed application with documentation to our Financial Representative for review and eligibility determination prior to your appointment. It takes 5 business days to process the fee scale application. You will then be informed of your rate.

How long does a fee-scale last?
An expiration date will be set when you are approved. It is your responsibility to re-apply for the fee-scale before it expires. If not, you will be responsible for the full cost of services after it expires.

Other Important Information

  • If your income level qualifies, you will be required to meet with a Case Management Representative to apply for state or federal coverage or insurance.
  • All income and insurance information must be disclosed when applying for a fee scale. Falsifying or withholding information is an abuse of the fee-scale and may result in permanent discharge from Chase Brexton Health Services.
  • Our financial representatives will gladly answer any questions you may have regarding sliding fee scales or the application process.

I have other questions...
Call 410-837-2050.