Sliding Scale

At Nourish The Heart Counseling, we believe that everyone is entitled to good quality services and we understand that for various reasons at times insurance may not cover a service, someone may lose insurance coverage for their provider or various other reasons may prevent someone from being able to reasonably afford therapeutic, dietetic or medication services. As such, we do offer sliding scale options and encourage clients to have an open and honest conversation with their clinician when they may need to utilize these options. We choose to follow the The Green Bottle Sliding Scale Method, which is a tool that is flexible yet still provides some guidelines for us to follow when discussing sliding scale.

Here’s how it works:

The Green Bottle Sliding Scale Method, developed by Alexis J. Cunningfolk is a fee structure designed to accommodate clients with different financial means. It is a flexible payment range instead of fixed price for services. At Nourish The Heart Counseling, most services are going to be covered by insurance. Unfortunately, this cannot be applied to copays and co-insurance or deductibles as that is a contract we enter with insurance and that would be insurance fraud. The Green Bottle Sliding Scale Method is for individuals who do not have insurance coverage, who cannot use their insurance or for whom insurance does not cover a service. It allows clients to self-select the category they best fall into and the range that feels most comfortable to them. We do not check financials we take client at their word and expect for clients to be open and transparent and to let us know if their financial situation improves.

The Green Bottle Analogy: Think of it this way: Imagine a green bottle filled with liquid representing different payment options. The bottle is labeled with suggested payment amounts, such as “High Income,” “Medium Income,” and “Low Income.” Clients are invited to pick a marble that corresponds to their financial ability, no questions asked. This approach eliminates the discomfort of discussing finances and provides a safe space for clients to be honest about their capacity.

The full prices of the service (100% of services) It is the cost that the clinician would charge all clients regardless of sliding scale. If you have financial security, own property, have personal savings, you would not qualify for sliding scale. Alexis J. Cunningfolk explains that if you are “able to pay for “wants” and spend little time worried about securing necessities in your life, you have economic privilege and power in our community. This price is for you.”

The middle cost (75%-50% of services) This area acknowledges that some people would not be able to attend services if they had to pay the full fee for services, but they do not find themselves reflected in the financial need of those in the lowest cost. They are struggling with some debt or trying to build or rebuild savings. They have access to steady income but may be living paycheck to paycheck but they are not concerned about basic needs like shelter and food. These clients may need to ask others for some help, especially if therapy or services will be ongoing.

The bottom cost (30%-10%) this category reflects and acknowledgement that this group of clients would not be able to participate in therapy if services were not deeply discounted. This category also needs to be somewhat limited as to be able to pay our practitioners and keep our practice running we can offer no more than 2 slots at the bottom cost per clinician. Cunningfolk describes that folks in this category are “struggl[ing] to maintain access to needs such as health care, housing, food, child care, and are living paycheck to paycheck or are in significant debt.”