Sliding Fee Discount Program
Central Ozarks Medical Center offers a discounted fee to patients based on their household size and household income. The Sliding Fee Program includes fees for medical, dental and behavioral health services.
To determine eligibility, COMC will need to ask you to bring in personal financial information. Any information we ask you for will be strictly confidential. None of your personal information, financial or medical, can be released without your written consent. The information we are asking for is used solely to determine household size and household income. Applications are effective for a one-year period. Sliding Fee Discount Program participants must complete an application annually Discount Program applications must be completed, signed and approved prior to services being provided. All participants are asked to notify COMC of income changes as soon as possible after the change occurs.
All patients under 19 years of age must have a Medicaid denial letter to be eligible for the Discount Program.
- Household size includes all people living in your home EXCEPT for those you are not financially responsible for.
- Marital Status is not a factor when determining household size.
- Household income includes ALL INCOME earned by ALL INDIVIDUALS COUNTED IN HOUSEHOLD SIZE.
Acceptable Forms of Proof of Income
- Prior year’s tax return
- Paycheck Stubs
- Letter from employer showing Year-to-Date wages and dates of employment
- Letter from Social Security, Veteran’s Affairs, Employment Office, etc.
- Other proof of income may be accepted and will be determined on an individual basis
**Countable incomes are outlined later in this packet**
Insurance and Sliding Fee Discount Program
Under-insured individuals are still eligible for the sliding fee discount program. Provide your insurance card at the time you complete your application so a determination of the discount can be determined. Insurance will be billed first, then you will be given the discount you are eligible after the claim has been processed.
Dependent upon household income and household size the applicant will be assigned a flat fee level. Clinic based medical encounters, behavioral health encounters and Tier I dental encounters are all covered at the flat-fee the patient is eligible for based on the sliding fee discount scale.
Charges for Tier II dental procedures will be billed at a percentage of our normal fees and will be added to any Tier I charges for that visit.
Hospital Care - If you are an existing COMC patient participating in the Sliding Fee Discount Program and are admitted to the hospital by a COMC physician, the following Physician services are eligible for the Discount Program.
- Hospital Admission
- Hospital Follow-up
- Hospital Discharge
Other Services NOT Covered by the Sliding Fee Discount Program are as follows:
- Services related to motor vehicle accident and work comp services
- Lab/x-ray ordered by providers outside COMC
- Elective/Cosmetic Procedures to include, but not limited to:
- Removal of moles/skin tags (for cosmetic purposes)
- Certain Dental Procedures
- Any supply related to contraception
- Medical Weight Loss Program (SSHC)
- Exam and lab work required for Boxing
- Elective Dental Procedures
- Temporary Dentures
- Porcelain Crowns
Administration of Flu Vaccine with nurse only visit:
Discount Level A: $10.00
Discount Level B: $15.00
Discount Level C: $25.00
If the flu vaccine is administered at the time of an office visit, the normal discount fee will apply. COMC offers FREE Flu Vaccines at the Clinic’s Flu Fair. Inquiry may be made at reception.
The Sliding Fee Discount Program is retroactive for 30 days. All applications must be completed in FULL. Applications cannot be accepted without proper proof of income. Central Ozarks Medical Center is please to help meet your healthcare needs. We invite you to share this Discount Program information with others. If you have questions about this program, please speak to the reception staff.
Countable Income Includes:
- 1040 Federal Tax Form (Adjusted Gross Income is used from this document)
- 2-3 Consecutive Pay Stubs (Use total wages earned)
- Social Security Benefits (Benefit Letter – Total Award Amount)
- Unemployment Benefits
- Retirement Benefits (including Military Retirement)
No-Countable Incomes Includes:
- TANF or Food Stamps
- Social Security Income (SSI)
- Child Support
- Veterans Benefits (VA Benefits)
- Veterans Disability (VA Disability)
- Workers Compensation Payments
- Federal Tax Credits
- Scholarships/Awards used for education
- ncome of a child under 19 who is not required to file taxes as his or her income is less than the Federal Tax Filing Threshold.
DOWNLOAD SLIDING FEE DISCOUNT PROGRAM PACKET