Patient Policy
Proof of Income Policy
Siloam is not a free clinic. Generous financial donations fund us to offer sliding fee scale based on your income. Therefore, PROOF OF INCOME (POI) is required for all patients.
You must bring (1) of the following documents as your household Proof of Income:
- Tax Return from the previous year,
- 3 recent pay checks,
- Award letter from the Social Security Administration, or
- Award letter from SNAP (Food Stamps)
Siloam patients MUST provide POI annually and bi-annually if your POI is paychecks.
Missed Appointment (No-Show) Policy
Starting in 2017, you will be charged $10 if you do not show up for your scheduled appointment. If
you repeatedly missed appointment, there will be penalties along with the possibility of transitioning
you out of Siloam depends on the level of missed appointments.
Due to high patient demand and limited appointment availability, it is very important that you keep
your scheduled appointments OR cancel or reschedule them a minimum of 24 hours in advance.
Canceling or rescheduling in advance gives another patient an opportunity to have your
appointment time.
HELP US HELP YOU remember your upcoming appointment by making sure we have your best
contact number. We send appointment reminders by voice and by text in advance of all scheduled
appointments. If you do NOT receive text or voice messages from us, it means we need to update
the number in your chart. Please let us know!
Insurance Screening Policy
Siloam Health exists to provide care for those who have nowhere else to go. In order to fulfill this
mission, we screen every patient for active insurance coverage one time annually. We will make you
aware when the screening will take place, and if you do have active insurance coverage we will help
you find a new healthcare provider that files to your insurance company.
Required Payment Plan for High Balance
Our goal for Siloam patients is that they are prepared to thrive in the current healthcare system. One
way to prepare our patients is to allow them how to take responsibility for their medical expenses.
Starting in 2017, we will require patients with over $100 balances to participate in a payment plan
that will best fit their financial situation.
We do not routinely prescribe opiate/pain medications for our patients. Your Siloam provider will
manage your pain using a varied and multidisciplinary approach using other medications, physical
therapy, and behavioral therapies whenever possible.
Nondiscrimination Policy
Click here to view Siloam Health’s patient nondiscrimination policy.
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.
Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.
You have the right to receive a Good Faith Estimate for the total expected cost of any healthcare items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.