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Clifton-Fine Hospital Sliding Fee Scale Payment Policy:
To provide needed financial assistance and to comply with Public Health Law 2807-k(-9-a) noted below, Clifton-Fine Hospital will provide financial assistance for patients with financial obligations to the Hospital for individuals with a household income equal to or less than three hundred percent (300%) of the Federal Poverty Level if the individual has no insurance or has exhausted health insurance benefits for that stay or service when the individual is unable to pay the full charges for that stay or service. Clifton-Fine Hospital does not provide financial assistance under this program for patient balances, including co-pays and deductibles, after insurance payments, as the allowed charges may already be discounted contractually.
Clifton-Fine Hospital will discount all self pay accounts by 20% if the account is paid in full within thirty (30) days of discharge or service or if the account guarantor signs a payment contract and makes the first payment within 30 days of discharge or service as per the Hospital’s “SELF PAY POLICY”.
Public Health Law 2807-k(9-a) states that self pay discounts should be equal to the discount taken by the hospital’s largest volume payer. Clifton-Fine Hospital is a designated Critical Access Hospital and Medicare is our largest volume payer. The formula to calculate Medicare discounts would effectively create no discount at all for self pay accounts. It is Clifton-Fine Hospital’s intent to provide a discount to all patients who do not have primary insurance and will do so based on the discount taken by our largest volume, non-governmental insurer, Blue Cross plus five percent (5%). Since the current contract with Blue Cross provides a fifteen percent (15%) discount, the current self pay discount will be twenty percent (20%). The Sliding Fee Scale program will be applied to remaining balances after the Self Pay Discount has been applied.
Public Health Law 2807-k(9-a)
 Sliding Fee Scale Policy
Sliding Fee Scale Application
Sliding Fee Scale Allowance Worksheet
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