The Community Health Center Primary Care Program at Monongahela Valley Association of Health Centers, Inc. provides assistance for qualified individuals and families; either insured, underinsured, or uninsured; based on a sliding fee discount for basic healthcare needs. Patient eligibility is determined by annual income and family size, and the application procedure is established and implemented to ensure that a non-discriminatory, uniform, and reasonable charge is consistently and evenly applied.

Every person who wishes to participate in the sliding fee discount program must apply for and be accepted into the program.  The patients’ dignity and privacy will be respected in every part of the program.  A patient does not have to fill out the sliding fee application in order to receive services at the clinic.

 Guidelines for Participation

  • Sliding Fee Discount Program recipients will be required to update their information yearly.  If any changes occur during the twelve month period, updated paperwork will be reviewed at either MVA location. At the end of the second 12 month period, the participant must fill out a complete recertification application and provide the same financial information that was needed to make their initial acceptance.
  • If proof of income is not documented within two weeks after the initial application, all discounts will be cancelled and the patient will be responsible for all services in full.  (See below for details)
  • Patients unable or unwilling to provide any level of documentation are not eligible to participate in the sliding fee discount program and will be required to pay 100% of their charges, until such time they provide documentation.  At the time documentation is provided, any eligible discount will be applied to previous services within the last 30 days.
  • The patient must make a payment at the time of service of either a $15 fee for those receiving a 100% discount or $20 for any other level of discount.  The $20 time of service payment is not in addition to the amount that they will be responsible for, it will go against the cost of the visit for that day.
  • Sliding Fee Discount fees must be made each visit.
  • Federal Poverty Guidelines change annually.  This could change the discount percentages for each participant.  Ask Front Office Staff for updated guidelines.

Services Covered by the CHC Primary Care Program:

  • Office Visit with Provider
  • X-Ray Services
  • Point of Care Labs
  • Diabetic Education
  • Basic Optical Services (contact fitting has an extra fee)
  • MVA Pharmacy Discounts
  • Acute Surgical Procedures

Service NOT Covered by the CHC Primary Care Program:

The program does not cover services provided to MVA patients by outside providers or diagnostic services such as the reading of X-Rays, Lab Fees, Specialist Fees, Hospital charges.  However, some of these providers may offer discounts that are equal to or better than those provided by MVA that you should ask about.

Sliding Fee Discount

Proof of Income

In order to qualify for the CHC Primary Care Program, proof of income is required.  A discount will not be applied until proof is received.  Any of the following documents may serve as documentation:

  • Tax Return
  • W-2
  • Pay Stubs
  • Social Security Statement
  • Medicaid denial letter
  • Proof of eligibility in other programs such as Social Security Disability (SSDI), Temporary Assistance for Needy Families (TANF), Free or Reduced School Lunch Programs, Other public assistance programs.
  • If you are claiming that you have no or close to no income you must provide a signed statement describing your living circumstances and how your basic needs are being met.

Click the button below for complete information and for a copy of a CHC Primary Care Application form.  You may also get information or an application at any of the MVA health center locations listed at the side of this page.

 

 

Monongahela Valley Association of Health Centers, Inc.  is accredited by The Joint Commission. To contact the joint commission please call  (630) 792-3000 or visit jointcommission.org.