Patients can pay for physician visits at the front desk or by mail.
If a co-payment is required at the time of a visit the patient must pay the
receptionist. If they are unable to pay the co-payment at that time they can
sign an agreement to pay in an allotted time period.
HealthCare on the Square offers eligibility for a
sliding fee
program. The sliding fee program is made possible through the federal government
and is based on discounted fees according to household income and member size.
If the patient is already enrolled in an insurance program they will be billed
first.
A patient can also qualify for financial assistance.
The medical center accepts payment with cash, check, or credit card.
Patient Information
Sliding Fee Program
Sliding Fee Application
Statement of Income
Financial Assistance
Request for Transcript of Tax Return
Release of Information
Payment Agreement
