Discounted Services Program

Discounted Services Program 

It is the policy of Pediatric Partners to provide essential services regardless of the patient’s ability to pay. We will charge persons receiving health services at the usual and customary rate prevailing in this area, however, health services will be provided at no charge, or at a reduced rate, to persons unable to pay for services.

Discount And Sliding Scale Fees

Maximum Annual Income Amounts For Each Sliding Fee Percentage Category (Except 0% Discount)

Maximum Annual Income For Each Sliding Fee Percentage Category

Application Requirements

You will need to submit an application prior to services rendered as well in its entirety with a full listing of all income in your home. Please download and print the application form (Sliding Fee/ Discounted Services Application), located on our forms page, and return them to our front desk staff with all required documentation to determine your eligibility.

Discounts are offered depending upon family income and size. The discount will apply to services received at our clinic, Pediatric Partners, but not those services which are purchased from outside such as reference laboratory testing, prescriptions, x-ray interpretation by a consulting radiologist, and similar services. In the hope that your economic health improves, discounts apply only for a period not to exceed three months. Please feel free to call us if you have questions of concerns about this program.

Note: Reported income includes income from all related persons in household and sources including gross wages, tips, social security, disability, pensions, annuities, veteran’s benefits, net business or self-employment, alimony, child support, unemployment, public aid, and other.

Additional Required Documentation 

In addition to the application forms above, you will also need to submit last year’s tax return as well as the last three current pay stubs for everyone listed in the home that is gainfully employed. We will not discriminate against any person receiving heath services because of their inability to pay for services or because payment for services will be made under Title XIX Medicaid or the social security act. We have an agreement with the state agency that administers the State plan for medical assistance under Title XIX Medicaid of The Social Security Act to provide services to person entitled to medical assistance under the plan.

If you have any questions in regard to this process, we invite you to speak with either the billing department or the clinic administrator at Pediatric Partners of Winter Haven: 863.940.0918.

550 Pope Avenue NW :: Ste 100
Winter Haven, FL 33881
P. 863.293.2144
F. 863.293.3732
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