​​All patients seeking health care services at Branches of Growth Mental Health Counseling, PLLC are assured that they will be served regardless of ability to pay. No one is refused service because of lack of financial means. This program is designed to provide free or discounted care to those who have no means, or limited means, to pay for their medical services (uninsured or underinsured). We do offer Financial Assistance programming to assist those in need:

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Sliding Fee Discount Program Policy

  
Branches of Growth offers a Sliding Fee Discount Program to all who are unable to pay for their services. Branches of Growth will base program eligibility on a person’s ability to pay and will not discriminate on the basis of an individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity. The Federal Poverty Guidelines are used in creating, and annually updating, the sliding fee schedule to determine eligibility.
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PROCEDURE: 

Requests for discounted services may be made by patients, family members, social services staff, or others who are aware of existing financial hardship. The Sliding Fee Discount Program will only be made available for clinic visits. Information and forms can be obtained from the Front Desk.

Administration: The Sliding Fee Discount Program procedure will be administered through the Office Manager.  Dignity and confidentiality will be respected for all who seek and/or are provided health care services.

Completion of Application: The patient/responsible party must complete the Sliding Fee Discount
Program application in its entirety. Staff will be available, as needed, to assist the patient or responsible party with applications. By signing the Sliding Fee Discount Program application, persons are confirming their income to Branches of Growth as disclosed on the application form.

Eligibility: Discounts will be based on income and family size only. Family is defined as: Individuals of a household both traditional and non-traditional families that are tied together financially or 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. Branches of Growth will accept non-related household members when calculating family size. Income includes: gross wages; salaries; tips; income from business and self employment; unemployment compensation; workers' compensation; Social Security; supplemental security income; veterans' payments; survivor benefits; pension or retirement income; interest; dividends; royalties; income from rental properties, estates, and trusts; alimony; child support; assistance from outside the
household; and other miscellaneous sources.

Income Verification: Applicants may provide one of the following: prior year W-2, two most recent pay
stubs, letter from employer, or Form 4506-T (if W-2 not filed). Self Employed individuals will be required
to submit details for 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 be used. Patients who are unable to provide written verification may provide a signed statement of income.

Discounts: Those with incomes at or below 100% of poverty will receive a full 100% discount for health care services. Those with incomes above 100% of poverty, but at or below 200% of poverty, will be charged a nominal fee according to the attached sliding fee schedule. The sliding fee schedule will be updated during the first quarter of every calendar year with the latest Federal Poverty Line Guidelines.

Applicant Notification: The Sliding Fee Discount Program determination will be provided to the
applicant(s) in writing, and will include the percentage of Sliding Fee Discount Program write off, or, if applicable, the reason for denial. If the application is approved for less than a 100% discount or denied, Branches of Growth will work with the patient and/or responsible party to establish payment arrangements. Sliding Fee Discount Program applications cover outstanding patient balances for six months prior to application date and any balances incurred within 12 months after the approved date, unless their financial situation changes significantly. The applicant has the option to reapply after the 12 months have expired or anytime there has been a significant change in family income. When the applicant reapplies, the look back period will be the lesser of six months or the expiration of their last Sliding Fee Discount Program application.

Refusal to Pay: If a patient verbally expresses an unwillingness to pay or vacates the premises
without paying for services, the patient will be contacted in writing regarding their payment obligations. If the patient does not make an effort to pay or fails to respond within 60 days,
this constitutes refusal to pay. At this point in time, Branches of Growth can explore options not limited to, but including offering the patient a payment plan, waiving of charges, or referring the patient to
collections.

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