Questions about the sliding fee scale
To make a request for discounted services, please visit the front desk of your local Peak Wellness Center office. Our friendly and helpful staff can answer any questions you might have, as well as assist you in filling out the required applications and paperwork.
How do I know if I qualify for the sliding fee scale?
Clients with incomes at or below 100% of poverty will receive a full 100% discount on their services at Peak. Those with incomes above 100% of poverty, but at or below 200% of poverty, will be charged according to the sliding fee scale. The sliding fee scale is updated during the first quarter of every calendar year with the latest federal poverty guidelines.
To qualify for the sliding fee scale, all alternative payment resources must be exhausted, including all third-party payment from insurance(s), Federal and State programs.
If I qualify for sliding scale, do I still need to pay for my visits to Peak?
Clients receiving a full discount will be assessed a $7 nominal fee per visit. However, clients will not be denied services due to an inability to pay. The nominal fee is not a threshold for receiving care and thus, is not a minimum fee or co-payment.
Can I qualify for the sliding fee scale if I have insurance coverage?
Under federal regulations, clients with insurance coverage do not qualify for the sliding fee scale.
Questions about the Sliding Fee Discount application process
We make discount mental health and substance abuse services available to all clients in need through a Sliding Fee Discount Application process. (Click here to download the application.)
The Sliding Fee Discount is based upon the annually published Federal Poverty Guidelines, establishing income and family size parameters for the Discount from full fee.
How does the Sliding Fee Discount Program work?
The Sliding Fee Discount Program procedure will be administered through the Chief Financial Officer or his/her designee. Information about the Sliding Fee Discount Program policy and procedure will be provided and assistance offered for completion of the application. Dignity and confidentiality will be respected for all who seek and/or are provided charitable services.
How do I apply for the Sliding Fee Discount Program?
The client/responsible party must complete the Sliding Fee Discount Program application in its entirety. By signing the Sliding Fee Discount Program application, persons authorize Peak Wellness Center access in confirming income as disclosed on the application form. Providing false information on a Sliding Fee Discount Program application will result in all Sliding Fee Discount Program discounts being revoked, and the full balance of the account(s) restored and payable immediately.
If an applicant is unable to be processed due to the need for additional information, the applicant has two weeks from the date of notification (date applicant notified PWC of need to apply for Program) to supply the necessary information without having the date on the application adjusted. If a client does not provide the requested information within the two-week time period, their application will be re-dated to the date on which they supply the requested information, and charges incurred in the interim period will be at the regular fee. Any accounts turned over for collection as a result of the client’s delay in providing information will not be considered for the Sliding Fee Discount Program.
How do I provide proof of income?
For income verification, applicants must provide one of the following:
- Prior year tax return
- Three most recent pay stubs
- Letter from employer
- Form 4506-T (if W-2 not filed)
Self-employed individuals will be required to submit detail of the most recent three months of income and expenses for the business. Adequate information must be made available to determine eligibility for the program. Self-declaration of income may only be used in special circumstances. Specific examples include participants who are homeless.
Clients who are unable to provide written verification must provide a signed statement of income, and why (s)he is unable to provide independent verification. This statement will be presented to Peak Wellness Center’s Chief Financial Officer or his/her designee for review and final determination as to the sliding fee percentage. Self-declared clients will be responsible for 100% of their charges until management determines the appropriate category.
If approved, how is my sliding fee scale discount decided upon?
Discounts will be based on income and family size only. Peak Wellness Center uses the Census Bureau definitions of each:
- Income includes earnings, unemployment compensation, workers compensation, Social Security, Supplemental Security Income, public assistance, veterans’ payments, survivor benefits, pension or retirement income, interest, dividends, rents, royalties, income from estates, trusts, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Noncash benefits (such as food stamps and housing subsidies) do not count.
- Family is defined as a group of two people or more (one of whom is the householder) related by birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family.
Downloadable financial documents
Still have questions about payment and insurance for Peak services?