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Welcome to Crescent Community Health Center!

Our team is ready to work with you and deliver respectful and affordable health care. Let’s get started!

Intake Packet

On average, new patient registration takes approximately 20-30 minutes to complete. Want to skip the wait? Complete the new patient registration packet prior to your appointment!

What is included in the packet?

  • Demographic Form – provides information such as name, date of birth, race, and address.
  • Health History Form – health history questionnaire that is utilized by our care teams to provide you with personalized care.  

To complete the ADULT intake packet electronically, CLICK HERE.

To complete the PEDIATRIC intake packet electronically, CLICK HERE.


Financial Assistance & Sliding Fee Scale

What is a sliding fee scale? A sliding fee scale is a discount applied to the cost of your care based on total household size and income. Crescent will attempt to assess all patients for the sliding fee scale discount including those who are insured. In order to be assessed for the sliding fee scale, you must provide one of the following sources of information:

  • Current paystubs (paystubs must show GROSS income) for the past 30 days (2 paystubs if paid bi-weekly, 4 paystubs if paid weekly); for both patient AND spouse, if married.
     
  • Tax forms (Federal 1040, W2, or 1099); for both patient AND spouse, if married.
     
  • If you receive Social Security income, unemployment and/or pension monies that are direct deposit, you may provide your bank statement showing 30 days of activity OR the letter from Social Security or unemployment indicating the amount you are paid.
     
  • Eligibility Notice from the State (Notice of Decision/Action (IA resident), SNAP report (IL resident) or Food Share Report (WI resident).
     
  • Wage A verification form. This form allows us to partner with Iowa Workforce that shows a person’s income over the previous FOUR quarters. Only patients employed in Iowa and do not receive unemployment are eligible to submit this form. 

How do I provide my proof of income?

Fax: (563) 690-0373
Mail: 1690 Elm St. STE 300 Dubuque, IA 52001
Email: please send via secure email to 
financials@crescentchc.org

You may also drop off at the clinic or bring to your next appointment

Use the button below to view our sliding fee scale. You can determine your discount percentage based on total household size and income. Patients who qualify for a 100% discount will still be asked to pay the nominal fee.

For more information, please contact our Financial Counselor at (563) 690-2891.

 


Insurance Assistance

What insurances do we accept?

  • Medicaid 
  • Medicare 
  • Most private insurances
  • Sliding fee scale payment

If you are seeking health insurance, please contact Angela Petsche. Assistance is available by appointment only. Please use the contact information below the to schedule a FREE consultation.

Phone: (563) 552-8080
Email: 
APetsche@crescentchc.org


Billing

Our online bill pay feature is free, convenient, and secure! You will have the option to make one-time payments, auto-pay, payment plans and sign up for e-statements. For additional information, watch our easy-to-follow online tutorial.

To make a payment, CLICK HERE!

Need help understanding your bill? Don’t worry, we’re here to help and make it easier. Use the button below to view a breakdown.


Integrated Services & How to Schedule Appointments

Crescent offers primary and preventative health care services that address a person’s basic health care needs related to medical, dental, and/or brain health issues. 

What services are offered?

Medical: Call (563) 690-2863 to schedule an appointment 

  • Physicals / Wellness Exams
  • GYN Exams & IUD Insertion or Removal
  • Vaccinations
  • School & Sports Physicals 
  • Minor Procedures

QuickCare: walk-in appointments only

  • Acute Headache
  • STI Screening
  • Fevers
  • Cough
  • Infections/Abscesses 
  • Allergy Symptoms

Dental: Call (563) 690-2852 to schedule an appointment 

  • Routine Exams
  • Hygiene Screenings
  • Fillings
  • Extractions 
  • Root Canal Therapy 
  • Stainless Steel Crowns
  • Dentures

Brain Health: Call (563) 690-2850 schedule an appointment 

  • Therapy 
  • Medication Management

FAQ's

How often will I receive a statement from Crescent Community Health Center?
If you have a balance, you will receive a statement at least once a month. Statements will continue until payment is made in full or moved to bad debt.

Why did I receive a statement when I have insurance?
You are financially responsible for the charges your insurance plan does not cover. If your insurance doesn’t cover the services provided, you will incur a balance.

What if I cannot pay my entire balance?
In most situations, a payment plan may be established depending on your balances due. For other payment options, please contact our Financial Counselor at (563) 690-2891.

How can I pay my bill?

  • Online Bill Pay
  • Phone: (563) 690-2891
  • Mail: 1690 Elm St. STE 300 Dubuque, IA 52001
  • Pay at clinic

Why did I have to pay at time of service?
A nominal charge for an office visit is requested at the time of service. Any balance remaining after the sliding fee scale discount and nominal fee payment has been applied will be billed to the patient. 

If you have insurance, a copay may be collected at time of service.

How am I eligible for a discount?
You must provide proof of income in order to be eligible for our sliding fee discount. Once you provide, your charges will be reduced according to the percentage determined.

How often do I need to provide proof of income?
You must provide proof of income annually.