Sliding fee scale
Iliuliuk Family and Health Services, Inc. (IFHS) has a policy of providing medical care regardless of a patient’s ability to pay. In support of this policy, IFHS has developed a sliding discount (“discount”) schedule based on household income and household size.
IFHS has a uniform fee schedule based on regional fee analyzer data reasonably adjusted for local costs. Eligible patients will receive discounts from the fee schedule based on their household income and household size.
Gross income is used for eligibility purposes. Tax returns are the preferred documentation of income. IFHS requires that at a minimum, patients requesting discounts provide the name, relationship to patient, age, gender, date of birth, monthly income and employer of every individual in the household, and sign a statement certifying this information is correct. Other proof of income includes prior year completed income tax forms, pay stubs from the last three months, unemployment or other benefits/income receipts, and/or letters of income verification from two other individuals or from the employer(s). Eligibility will be reviewed for each active patient at the first encounter greater than one (1) year after the last review.
Patients who chose not to provide proof of eligibility will not be eligible for any discounts. Patients who present without the necessary information will be given a 30 day grace period to turn in information and qualify for a discount.
The Schedule of Discounts are based on the Alaska State poverty level table. This table is updated annually. IFHS will maintain the most current poverty level table in order to determine patient eligibility for discounts.
IFHS has a uniform fee schedule based on regional fee analyzer data reasonably adjusted for local costs. Eligible patients will receive discounts from the fee schedule based on their household income and household size.
Gross income is used for eligibility purposes. Tax returns are the preferred documentation of income. IFHS requires that at a minimum, patients requesting discounts provide the name, relationship to patient, age, gender, date of birth, monthly income and employer of every individual in the household, and sign a statement certifying this information is correct. Other proof of income includes prior year completed income tax forms, pay stubs from the last three months, unemployment or other benefits/income receipts, and/or letters of income verification from two other individuals or from the employer(s). Eligibility will be reviewed for each active patient at the first encounter greater than one (1) year after the last review.
Patients who chose not to provide proof of eligibility will not be eligible for any discounts. Patients who present without the necessary information will be given a 30 day grace period to turn in information and qualify for a discount.
The Schedule of Discounts are based on the Alaska State poverty level table. This table is updated annually. IFHS will maintain the most current poverty level table in order to determine patient eligibility for discounts.
nominal fee - medical/behavioral health and dental
IFHS requires that patients otherwise eligible for 100% discount pay a nominal fee of $25.00 each for medical and Behavioral Health visit,. For a Dental visit IFHS requires that a $ 40.00 per visit charge be assessed as a nominal fee. If a patient presents for medications and or services which are less than $25, the lessor amount applies to the patient, no sliding scale will be done. Nominal fee charges are subject to change.
excluded charges
The following charges are excluded from eligibility for discount:
Patients can appeal a decision to exclude charges from eligibility for discount by following IFHS patient grievance procedures.
- Dispensary stat fees.
- Dispensary restock fees.
- Any Dental procedure not covered by Medicaid
- Prescription charges for Viagra or Cialis.
- Plan B more than once per month.
- Any cosmetic procedures.
- Any non-medically necessary procedures.
Patients can appeal a decision to exclude charges from eligibility for discount by following IFHS patient grievance procedures.
2016 poverty guidelines for alaska
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