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INDIAN RIVER COUNTY HEALTH DEPARTMENT <br /> FEE SCHEDULE --Effective Oct 1, 2005 <br /> IRCHD POLICIES <br /> School Year Policy Regarding Physicals: If a patient is already established at IRCHD as a primary care patient, physicals will be given <br /> based on sliding fee scale; however, if they are new to the clinic for medical care, they must pay the advance fee of$32.00 unless they <br /> register as a primary care patient and transfer all current medical records to the health department. <br /> County of Residence: (Primary Care) If a patient has Medicaid, other confirmed medical coverage, or prepays out of county charge,we will <br /> see them in the clinic and bill for service. However, all sliding fee or zero pay patients must be seen at the health department in the county of <br /> their residence. Failure to show confirmation of county residence will result in payment of 100%until such confirmation is obtained. <br /> (Exception to this rule will be for treatment of communicable diseases and family planning services. <br /> Insurance will not be billed for family planning services. <br /> Employee medical care will be provided based on approved policy and procedure. <br /> Hepatitis A&B vaccines are provided free of charge to ages 0-18 per CDC Vaccine for Children guidelines. If a patient has Medicaid <br /> coverage. Medicaid will cover Hep A&B to age 21. Vaccines will not be provided on a sliding fee scale for non-established patients over <br /> the age of 18. EXCEPTION: Vaccine will be provided free of charge or on reduced fee if vaccine is treatment for communicable disease. <br /> Anonymous HIV Testing: $25.00 fee applies to all patients who request HIV test. However, test will be given regardless of ability to pay. <br /> Reduced fee will be accepted for hardship cases. <br /> Per agreement with Partners in Women's Health, a reduced fee of$10.00 will be billed to those patients who are pregnant and referred <br /> to IRCHD for HIV testing. <br /> Access to dental services will be limited to those patients who make 200%or less of the Federal Poverty Level. (Effective May 8, 2002) <br /> 9/12/2005CLFEE2005-06 Page 8 of 8 <br />