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CABAkRUS COUN!~ HEALTH D£P.LRIMENT '
<br /> }~TER~NAL HEALTH PROG~ FEE SCALE - (GROSS INCOME)
<br />
<br /> 1 S0- 5,769 S 5,770- 7,212 $ 7,213-$ 8,655 $ 8,656-$10,098 $10,099-$11,539
<br /> 2 $0- 7,729 $ 7~730- 9,66z $ 9,663-$11,595 $11,596-$13,528 $13,529-$15,&59
<br /> 3 $0- 9~689 $ 9~690-12~112 $12~113-$1&,535 $1&,536-$16,958 $16,959-$19,379 $19,380+
<br /> a S0-11~649 $11,650-14,562 $14,563-$17~47S $17,&76-$20,388 $20~389-$23,299 $23,300+
<br /> 5 $0-13,609 $13,610-17,012 $17,013-$20,&15 $20,416-$23,818 $23j$19-$27,219 $27.220+
<br /> 6 $0-15,569 $15,570-19,46l $19~463-$23,355 $23,356-$27,248 $27~249-$31,139 $31,140+
<br /> 7 $0-17,529 $17~$30-21,912 $21.913-$26j295 $26~296-$30,678 $30,6?9-$35,059 $35~060~
<br /> ~ $0-19,489 $19,&90-24,362 $24,363~$29,235 $29.236-$3&,108 $3&,109-$39,979 $39,980+
<br /> 9 $0-21,&49 $21,450-26.812 $26,813-$32,175 $32,176-$37,538 $37,539-$42~899 $42,900*
<br /> 10 $0-23,&09 $23,410-29~262 $29,263-$35,115 $35~116-$~0~968 $&0,959-$46,$19 $46,820+
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<br /> For family units ~ith more tha~ 10 members, add $1,960 for each adOitional member.
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<br />Complete (initial visit) $ 8.00 S17.00 S25.00 S3&.00
<br />Revisit (subsequent visit) S 5.0~ $~0.00 S~4.00 5t9.00 $24.00
<br />Rhogam (£or Rh negative ~atient$) S 7.00 $14.00 S21.00 S28.00 S35.00
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<br /> Eligibility will be determined with each pregnancy. Income will be determined by declaration of income by patient;
<br />however, verification can be requested ac the discretion of the eligibility specialist. Patients will be expected to pay
<br />according'to ~he above fee scale.
<br /> Patients on sliding fee scale who fail ~o pay during a pregnancy and return to the health department for care with a
<br />subsequent pregnancy will be referred tothe program supervisor or nursing director prior to acceptance for care.
<br /> Patientswith hospital insurance and excessive income will be referred to private care. If the patient is unable
<br />obtain medical care within C~barrus County (i.e., lack of uR-front funds, owes doctor for previous services, doctors'
<br />appointment~.filled) ~patient can receive care at the Cabarrua Count~ Health Department. Eligibility specialist will
<br />verify/docdmen?(usfng special form) that "patien~ is unable to receive care.'~
<br /> Insurance patients will be placed in the full pay category regardless of income. Insurance will be filed by the health
<br />department, 07/01/87 (Revised to be effective 07/01/88)
<br />
<br />07-21-87: Approved by Cabarrus County Board of Health and County Commissioners, to be effective 07-21-87.
<br />
<br />12-07-87: Fee scale revised by Cabarrus County Board of Health and County Commissioners, to be effective 12-07-87.
<br />05-26-88: Scale revisiom approved by Cabarrus County Board of HealthL
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