As a National Health Service Corps Site

NHSC.hrsa.gov

WE PROMISE TO:

  • Offer discounted fees for patients who qualify
  • Not deny services based on a person’s:
    • Race
    • Color
    • Sex
    • National Origin
    • Disability
    • Religion
    • Sexual Orientation
  • Accept Most all Insurances, including: 
    • Medicaid (MO & IL)
    • Medicare & Medicare Supplements

POLICY:

It is the policy of MedStop One to provide essential medical services regardless of the patient’s
ability to pay. Discounts are offered based upon family/household size and annual income. A sliding fee
schedule is used to calculate the basic discount and is updated each year using the Federal Poverty
Guidelines. Once approved, the discount will be honored for six months, after which the patient must
reapply.

DISCOUNT APPLICATION PROCESS:

A completed application including required documentation of the home address, household income, and
insurance coverage must be on file and approved by the business office before a discount will be
granted. If the applicant appears to be eligible for Medicaid, a written denial of coverage by Medicaid
may also be required. Adolescent patients seeking confidential care are exempt from the application
process, and services are provided at the nominal rate.

Review and complete the following application, and submit along with the required financial documents
supporting the application for review by me (David Cantrell, Administrator). You can drop these off at
our office, fax them (573-339-7887) or email them to medstopone@gmail.com.

Please feel free to call US at 573-335-4100 if you have any questions.

Sliding Fee Schedule & Application

Sliding Fee Schedule Policy Statement

MedStop One 2016 Discount Fee Schedule

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