Discounted Services

Sliding Fee Scale Discount Program

 

First Choice Primary Care offers a Sliding Fee Scale Discount Program to all eligible uninsured and underinsured patients. Discount levels and nominal fees are based on household size and gross household income.  All applications for the Sliding Scale Fee program must be completed in person. Applications are accepted at time of service. 

Patients applying for the Discount Program must show proof of income or provide documentation as required by First Choice Primary Care. Patients who fail to comply with this requirement will be responsible for the full bill. 

Sliding Fee applications must be renewed on an annual basis or as determined by FCPC.  

 

Discount Program Application (English)

Discount Program Guidelines (English)

 

Please bring the following documentation to your initial visit. 

 

  • Photo ID

 

  • Proof of Address - 2 forms are required.
    • Utility Bills
    • Lease agreement
    • Letter from homeless shelter
    • Other pieces of mail showing current address. 

 

  • Proof of Income - one of the following is required for proof of income for all members of the household:
    • Paycheck stubs showing one month's worth of income (2 biweekly or 4 weekly)
    • If you are self-employed, you may choose to show last year's tax return. 
    • If you are paid in cash, you will need to provide a letter from your employer stating your avarage rate of hourly pay and amount of hours worked. 
    • Child Support Income
    • Social Security or Disablity Award Letter
    • For patients without any income - We require an official document such as: a statement from the IRS (Non-Filers statement, income tax return); a statement from the unemployment office, a termination letter from the most recent employer, verification of benefits from the DFCS office, or letter from person who is financially supporting you. 

 

The following government agencies can help you locate many of the documents required. 

 

Bibb County Department of Labor:  3090 Mercer University Dr.  (478) 751-6164
Social Security Office:  3530 Riverside Drive (478) 477-7950
Internal Revenue Service:  600 North Avenue (478) 752-8243
Bibb County DFCS: 456 Oglethorpe St. (478) 751-6051

 

Houston County Department of Labor:  96 Cohen Walker Dr. (478) 988-7130

Social Security Office:  220 Carl Vnson Pkwy.  (866) 931-7084

Houston County DFCS:  92 Cohen Walker Dr.  (478) 988-7600

 

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