Part of our mission is to see the uninsured and underserved of our community.  We are able to do this by offering a sliding scale discount based on income to our uninsured patients.

 

Your income information is completely confidential and is not provided to any governmental agency for any reason. No one will be denied access to services due to inability to pay. The available discounted/sliding fee schedule is based on family size and gross annual income.

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Documentation to confirm eligibility for the sliding scale is required. Documentation will have to be resubmitted every six months to keep your sliding scale discount.

 

Please provide documentation that applies to your situation prior to your first appointment and every 6 months after:​

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• Paystubs for the last month. This means 4 weeks of paystubs.

  • If you are paid every two (2) weeks  this means two (2) paystubs. 

  • If you are paid every four (4) weeks this means four (4) paystubs. 

• Most recent SNAP or TANF Benefit Statement.

• Most recent Social Security (SSA)  Benefit Statement.

• Most recent Unemployment Statement.

• Most recent tax return (accepted through June).

• Most recent statement of earnings from employer; to include pay rate, estimated hours and frequency printed on company letterhead.

• If you are unemployed we have a letter of Financial Support for a family member or friend to complete and sign who is providing support.  For the letter in English click here. For the letter in Spanish click here. 

 

If possible please provide your income documentation before your visit so your check in process will be brief and your wait time minimized. There are four ways for Olde Towne to receive your information:

• in person to the front desk

• email to office@otmdc.org

• fax to 757-220-1953

• mail to OTMDC, 5249 Olde Towne Road, Williamsburg, VA 23188

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​If you have not provided the requested documentation at the time of your appointment, there may be a chance your appoint will be rescheduled. If our office does not receive any missing information by the  next business day you will be billed 100% of the standard rate for the services provided and any labs drawn will need to be repeated.