Ammonoosuc Community Health Services, Inc.
Payment & Insurance Information
Payment & Insurance Information

Payment & Insurance Information

Insurance

We accept most commercial insurances. Please bring your insurance card, and be prepared to pay your copay at the time of each visit upon check-in.

Medicaid

Please bring your Medicaid card with you to each visit.

Medicare

Please bring your Medicare card with you. After Medicare and secondary payers have applied payment to your claim, you will be billed for the remainder of the balance. The sliding fee scale will then be applied to this balance.

Health Insurance Marketplace

If you are currently uninsured and need help with the Health Insurance Marketplace, ACHS can help. ACHS has Health Insurance Marketplace Certified Application Counselors (CACs) to help you with the Marketplace application process.

Call 1-866-201-5076 option 3 to set up an appointment with an ACHS CAC at any one of our 5 sites. You do not have to be an ACHS patient to use one of our Certified Application Counselors.

Sliding Fee Scale Financial Assistance Program

A sliding fee scale is an adjustment in the cost of services for patients without insurance. The amount of adjustment is based upon gross household income. Rates are set by the government. To determine eligibility, a patient must complete the Sliding Fee Scale application, show 3 consecutive pay stubs for all employed persons who are part of the household. Child support, worker’s compensation, alimony, disability and Social Security checks are considered income. If self-employed, you will need to provide a copy of your most recent tax return (Schedule C) with your application.

Until your application is accepted, you will be expected to pay in full for services rendered. Upon approval, you will receive a reduced rate based on your income, it will be applied to your visits and a minimum payment will be required at each visit.

Those who are eligible must reapply every 6 months, it is the responsibility of the patient to keep their application for financial assistance current.

The ACHS Sliding Fee Scale is also accepted by some area specialists, and may be applied to some lab work at area hospitals.

Please ask an ACHS staff member for an application.

Self-Pay Patients

For those without insurance who are not income eligible for financial assistance, payment for services is expected at the time of each visit. Please be sure to bring cash, check or a credit card with you.

Accepted Forms of Payment

We accept cash, checks, debit and credit cards (Visa, Mastercard, Discover and American Express) for payment of services.