Sample Sliding Fee Discount Application

Whether patients are facing financial problems or they don't have insurance, you will always have patients that have difficulties paying for their health services.

If you decide to offer a discount to patients in need, there are steps you must take to not only protect your practice financially, but also to stay within regulatory guidelines.

One way you can offer a financial break to both low income and self-pay patients is to create a sliding fee schedule.

Read 13 Steps to Creating a Sliding Fee Scale for Your Healthcare Practice and download this sample sliding fee discount application (Word doc). Edit it according to your policy.