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For more information or to obtain an appointment or walk-in status call our clinics appointment line (714) 441-0411. We are open Monday thru Friday from 8:00 am to 5:30 pm and 1st Saturday of the Month, by appointment only for your convenience.

Medical Consultations
On Site Laboratory Services
Urinalysis
Diabetes and Cholesterol Check
HIV Testing
Breast Exam
Pap Smear
Ultrasound
Mammograms
EKG
BMI
Pap Smears
Mammograms and Referrals
Cervical Cancer Screening
Osteoporosis Screening
Family Planning
Birth Control
Pregnancy Test
Prenatal Care
Hormone Therapy- Menopause Screening  Female and Male Reproductive Services
Sexually Transmitted Infections
Family Planning
Birth Control
Pregnancy Test
STD Testing
HIV Testing
Blood Pressure Check
Prenatal Specialty  Referrals
Cervical Cancer Screening
Pap Smear
Urinalysis
Weight Loss
Fetal Presentation
Fetal Heart Monitor
Ultrasound
School Entry Physical Exam
Treatment for Chronic and Acute Diseases
Physical Exam Evaluation
Snellen
Anemia Screening
Nutritional Counseling
Immunizations

2018 Sliding Fee Scale

A measure of the income issued each year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings in Marketplace health insurance and Medicaid and CHIP coverage. The above federal poverty level (FPL) income numbers for 2018 are used to calculate eligibility for Medicaid and the Children's Health Insurance Program (CHIP).

To establish a sliding fee scale in conformity with federal poverty guidelines and requirements based upon patients’ income and household size.

A Sliding Fee Discount Program will be provided to patients and their household members with incomes at or below 200% of the current federal poverty guidelines, based on their household size. This policy is intended to adjust charges based on the patient’s ability to pay in order to address financial barriers to care and is consistent with HRSA Program Information Notice 2014-02.

The Sliding Fee Discount rate schedule and policies for administration of the Sliding Fee Discount Program will be updated and reviewed on an annual basis.

  1. In February of each year, NOCRHF will obtain the updated federal poverty income guidelines from the Federal Register and will update the sliding fee discount schedule. In conjunction with the discount schedule review, the policies and procedures related to administration of the sliding fee discount program will be reviewed and updated if needed.
  2. The annual update to the sliding fee discount schedule and any policy updates proposed will be presented to the Executive Director for review. The Executive Director will present the discount schedule and policy updates to the board of directors for review and approval. Once approved, the sliding fee discount schedule shall be updated.
  3. During the update process, barriers to care will be assessed including a review of patient satisfaction surveys and other quality improvement instruments, if needed.
  4. On March 1 of each year, the updated sliding fee discount schedule will be put into effect.

NOCRHF shall ensure that patients are informed about availability of the Sliding Fee Discount Program (SFDP)

  1. New patients requesting appointments or other services are informed of the availability of the sliding fee discount program. At the time of all telephonic appointment scheduling, all patients requiring documentation to qualify for the SFDP will be informed of the required documents.
  2. An informational brochure/handout about the discount program is given to each new patient at the time of initial registration.
  3. NOCRHF shall post a notice about the Sliding Fee Discount Program at the reception area/intake desk and shall provide reminders to patients regarding the availability of the sliding fee through printed messages on billing statements and other means.

NOCRHF shall maintain a uniform process for the sliding Fee Discount Program applications and will verify patient eligibility no less than annually.

  1. As part of the registration process, patients are asked if they are uninsured. If so, patients are assessed for eligibility for the sliding fee discount program.
  2. Patients applying for the Sliding Fee Discount Program are asked to provide household size and written verification of monthly income. Household size is defined as all residents living in a single family dwelling unit. Examples of written verification include a recent (within 15 months) W-2 form or the two most recent pay stubs (within 2 months). Additional verification includes unemployment letter, letter from parent or caretaker, or other income from partner or spouse. A list of sources of income are listed on the Fee Assessment Form.
  3. Temporary eligibility will be granted for those patients who have stated that they have written verification of monthly income but did not bring it to the appointment. Patients will be expected to bring verification of monthly income to the clinic at their next visit. The patient will be asked to sign the Self Declaration of Income form until verification is brought in.
  4. Self-declaration can be used when income cannot be reasonably documented. Patients who are unable to provide written verification must submit, a signed statement of income with an explanation of why independent verification cannot be provided.
  5. If a patient qualifies for the Sliding Fee Discount Program or receives temporary eligibility, the appropriate sliding scale discount shall be granted. The sliding fee scale encompasses a nominal fee, and three categories for medical and behavioral health services. No discount is given to patients above 200% of the federal poverty guideline. To determine the sliding scale appropriate for each qualified patient, the total household income shall be compared to the sliding fee scale chart.
  6. For insured sliding fee patients, the out-of-pocket expense a patient incurs, who is eligible for a discount, is not more than the discounted amount the patient would owe if uninsured.
  7. Patients applying for the Sliding Fee Discount Program will be informed that they are obligated to contact NOCRHF if their income or household status changes at their next visit. Patients will be asked to verify their income annually for the sliding fee to apply.
  8. The Executive Director has the authority to waive the charge to the patient, based on an individualized determination, in cases where it is determined that the charge represents a barrier to care.

NOCRHF will maintain uniform minimum payment terms for Sliding Fee Discount program services.

  1. NOCRHF will request a nominal fee from patients at or under 100% of the federal poverty guidelines as follows:
    Medical Clinic Consults: $25
  2. Sliding fee discounts apply to patient visits and related procedures.
  3. When a sliding fee scale patient is in need of x-ray, pharmacy or other services not provided directly by NOCRHF, and not in the approved scope of project, the patient is responsible for paying for the service.
  4. For outside laboratory services, NOCRHF has an arrangement with a laboratory provider, who bills directly for insured patients, and bills NOCRHF for uninsured patients. NOCRHF charges patients the amount charged by the laboratory provider (rounded up or down to the nearest dollar), which represents a discount from market rates. This charge does not include a markup or administrative fee.
  5. For all services that include supplies and equipment that will result in a separate charge from the office visit, patients will be informed of the total amount of out-of-pocket costs for the supplies or equipment; and informed about any payment plans, if available.

NOCRHF shall maintain consistent expectations for payment on outstanding balances and clearly communicate these expectations.

  1. NOCRHF shall request and expect payment at time of visit. Patients that cannot make their payment at the time of service will be asked to bring payment to the next visit.
  2. NOCRHF’s sliding fee patient accounts are handled in a manner consistent with payment and collection policies. Patients with balances will be billed monthly. After 90 days with no activity on an account, NOCRHF’s billing department will work with patients to establish payment plans.
  3. The sliding fee scale is available to insured patients with payment responsibilities, who meet the income requirements. The patient will be charged no more than the discounted pay class for which s/he is eligible. This amount must be greater than the nominal fee.
  4. For patients without revenue at the time of visit, or cannot make payment for nominal services, labs, or medication, NOCRHF will make every effort to facilitate care on behalf of the patient, despite their immediate ability to pay. The CEO will have discretion over financial decisions most beneficial to the patient, including adjusting payments.

Want to schedule an appointment?

Call us at (714) 441-0411