Self-Pay Discount Program
Self-Pay Discount Program
Sutter North Medical Foundation provides patients who are uninsured and do not qualify for charity care, an opportunity to reduce their out-of-pocket healthcare costs throug a Self-ay Discount Program.
Who is eligible for a Self-Pay discount?
A patient's eligibility for Sutter North's Self-Pay Discount Program is based on the following tiers.
Tier 1- Patients whose household income exceeds 400% of the Federal Poverty limit may be eligible for a 25% discount on billed charges.
Tier 2- Patients whose household income is between 301-400% of the Federal Poverty Limit may be eligible for a discount of services to equal Medicare allowable rates.
How do I receive a self-pay discount?
At the time of service, uninsured patients requesting Tier 1 discount can be given a 25% discount.
This discount is available to qualifying patients on billed charges when payment is received in full, excluding cosmetic procedures.
For patients requesting Tier 2 discount, an Uninsured Patient Discount Application including supporting income documentation must be submitted to Sutter North's Patient Financial Services department for approval. Approval of paperwork is required prior to Tier 2 discount. Approved patient must reapply for discount annually.
What documentation is required for Tier 2 discount?
- Copies of pay stubs or proof of income for the last twelve months or last year's W2 forms
- Bank statements for the past three months
- Proof of other income sources (pension, disability, AFDC, social security, unemployment, other support, investments)
- Proof of no medical insurance coverage (Example: letter from insurance giving termination date)
- Denial letter from Medi-Cal
Charity Care
Patients who face financial hardship and have a household income below the 300% Federal poverty level may qualify for Charity Care. Please contact our Patient Financial Services Department for more information regarding your eligibility.
Who do I contact for help?
If you have questions or need help with available programs please visit any of our care centers or contact Sutter North's Patient Financial Services Department at (530) 749-3562