Sliding Fee Discounts
Our sliding fee discount program is designed to provide free or discounted care to those who have no means, or limited means, to pay for their behavioral health services (uninsured or underinsured). Eligibility is based only on income and family size, and discount percentages are determined by Federal Poverty Guidelines.
This program follows parameters set by the federal Health Resources & Services Administration guidelines (Section 330(k)(3)(G) of the Public Health Service (PHS) Act; 42 CFR 51c.303(f), 42 CFR 51c.303(g), 42 CFR 51c.303(u), 42 CFR 56.303(f), 42 CFR 56.303(g), and 42 CFR 56.303(u).
Sliding Fee Discounts
The following income guideline may help determine if you are eligible for Community Integrated Health Services, LLC’s Sliding Fee Discount program. The intent of providing the following information is to enable you to determine if you or your household may be eligible for this program. If you are in doubt, we encourage you to submit this application for consideration.
Application Process
- Client completes Sliding Fee Discount Application Form:
- Provides full name, date of birth, Social Security number, and relationship to the client for each member of the household
- Provides income verification documentation per the list on the application.
- Signs application form
- Submits signed application form and income verification to receptionist or mails to:
Accounting Claims Department
Community Integrated Health Services, LLC
PO Box 1447, Chehalis, WA 98532
- Accounting Claims Department staff:
- Reviews the application and makes determination
- Forwards recommendation to approve or deny application to executive staff
- Mails notification letter to client and notifies program manager
Questions
Questions about the Sliding Fee Discount program can be referred to:
Veronica, Accounting Analyst
By Email
AccountingClaims@cihealthservices.com
By Phone
(360) 447-1163