Sliding Fee Discount Program Policy/Procedure

It is the policy of Southwest Alabama Behavioral Health Care Systems to provide services regardless of the consumer’s ability to pay.

Southwest offers a Sliding Fee Discount Program to all consumers and each consumer is placed on the appropriate level of the sliding fee scale based on the reported annual income and family size. Annual income is the total amount of money earned during one year.

Income is considered to be:

  • gross wages/salaries
  • income from business and self-employment
  • unemployment compensation
  • workers’ compensation
  • Social Security
  • Supplemental Security Income
  • veterans’ payments
  • survivor benefits
  • pension or retirement income
  • royalties/dividends 
  • estates and trusts
  • alimony
  • child support
  • assistance from outside the household

Family is defined as: a group of two people or more related by birth, marriage, or adoptions and residing together; all such people are considered members of one family. Southwest also accepts non-related household members when calculating family size.  

All consumers seeking services are assured that they will be served regardless of ability to pay. The Federal Poverty Guidelines are used in creating the sliding fee schedule (SFS) to determine eligibility and are updated annually.  For example, Discounts: Those with incomes at or below 100% of the poverty threshold will receive a full 100% discount for health care services. Those with incomes above 100% of the poverty threshold, but at or below 200% of the threshold, will receive a nominal charge.

Notification of Fee

Southwest will notify consumers of the Sliding Fee Discount Program by:

  • Access to Care staff will inform all consumers (new or re-admitted) at the time of the initial call of the Sliding Fee Discount Program and of the necessary documentation that is required at the first visit in order to determine program eligibility.
  • Consumer Handbook is provided to all consumers at the initial visit. The policy is included in the consumer handbook that describes the Sliding Fee Discount Program.
  • Southwest posts notification of the Sliding Fee Discount Program in the waiting area of each outpatient facility.
  • Southwest’s website includes the availability of the Sliding Fee Discount Program in the Frequently Asked Questions section of the website.
  • The sliding fee scale is applied to all consumer charges except the $10 drug screen fee. Services will not be denied due to the inability to pay any fees. 

Administration: The Sliding Fee Discount Program procedure will be administered through the Finance Director.

Alternative payment sources: All alternative payment resources will be exhausted, including all third-party payment from insurance(s), federal and state programs. All consumers are eligible for the sliding fee program regardless of their insurance status. 

Completion of Application: The consumer or responsible party will complete the intake application with the Access to Care staff at the time of the initial call. The intake application will serve as the application for the Sliding Fee Discount Program and Access to Center services. Discounts are based on family size and income only.  The consumer will be informed by the Access to Care staff of the Sliding Fee Discount Program and the required documentation that must be presented at the time of the initial visit to finalize eligibility. Examples of appropriate documentation are prior year W-2, two most recent pay stubs, letter from employer, and or letter of self-declaration. If required documentation is not provided the consumer will be charged the full fee until such time as the required documentation can be obtained. Once presented the fees will be adjusted to the Sliding Fee Discount.

Refusal to Pay: Providing false information or failing to present the requested proof of income will result in the Sliding Fee Discount Program discounts being denied/revoked and the full balance of the account(s) restored and payable immediately. If a consumer verbally expresses an unwillingness to pay or vacates the premises without paying for services, the consumer will be contacted in writing regarding their payment obligations. Consumers will receive monthly statements providing the balance of their account and payments can be made toward the account balance upon receipt of the statement until paid in full. If the consumer does not make an effort to pay or fails to respond within 60 days, this constitutes refusal to pay.  

Changes to Income or Family Size: Consumers will be informed they must notify the Outpatient Office Manager of changes to their annual income and/or family size as needed. The Sliding Fee Discount Program will remain in effect and based on the consumer submitted proof of income and family size until services are no longer provided by the agency.