Bureau of Health Systems Development

Sliding Fee Schedule FAQs

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Click on the questions below to see their answers.

What is a discounted/sliding fee schedule?

Discounted/sliding fee schedules are a means of addressing the need for equitable charges for services rendered to patients. A discounted/sliding fee schedule is developed according to local fee standards and must be in writing. Discounted/sliding fees are based upon federal poverty guidelines, and patient eligibility is determined by annual income and family size. Schedules are established and implemented to ensure that a non-discriminatory, uniform, and reasonable charge is consistently and evenly applied.

For patients whose household income and family size place them below poverty, a nominal fee is charged. Patients between 101-200% of poverty are expected to pay some percentage of the full fee. A discounted/sliding fee schedule applies only to direct patient charges. Billing for third party coverage (Medicare, Medicaid, SCHIP or private insurance carriers) is set at the usual and customary full charge.

Why have a discounted/sliding fee schedule?

State requirements prescribe that a locally determined discounted/sliding fee schedule be used, and that services be provided either at no fee or a nominal fee, as determined by the provider.

Which patients are covered by a discounted/sliding fee schedule?

By joining the Arizona Loan Repayment Programs (ALRP) and accepting ALRP clinicians into your practice, you are agreeing to apply the discounted/sliding fee schedule equally, consistently, and on a continuous basis to all recipients of services in your site and/or location, without regard to the particular clinician that treats them.

How do we develop a discounted/sliding fee schedule?

When developing a discounted/sliding fee schedule, each safety-net provider should take the following into consideration:

  • The discounted/sliding scale fee schedule must be in writing and non-discriminatory;
  • No patient should be denied services due to an inability to pay;
  • Signage is posted to ensure that patients are aware that a discounted/sliding scale fee schedule is available to them;
  • Patients must complete a written application to determine financial eligibility for the discounted/sliding scale fees;
  • Every patient's privacy is protected;
  • Records are kept to account for each visit and the charges incurred (if any);
  • Patients below poverty are charged a nominal fee or not charged at all;
  • Clinical practice sites may establish at least three incremental percentages (discount pay classes) as they find appropriate between 101-200% of poverty;
  • Patients above 200% of poverty may be charged full fees for services.