Author Topic: Question on nsurance incurred patient fees vs cash patient incurred fees.  (Read 2001 times)


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I just stumbled across your website. Wow. Very informative. Thank you. I have a question regarding insurance incurred patient fees vs cash patient incurred fees. I work for a chiropractor in VA and was wondering if you could shed some light on the law regarding the proper way to do that. We have a sign posting our fees for both what we bill to insurance companies and what our “cash discount” fees are. We always have lots of questions from patients regarding the difference. I want to make sure we are following all the laws. We are allowed to have a “cash discount” fee, right?

Hi Bonnie,
We bill for several chiropractors and yours is a common question. Technically you are not suppose to charge cash patients a different fee than you charge insurance patients. However, there is a way around this. We were advised by a local Excellus BCBS provider rep that it is ok to have a sliding scale for your charges where the amount that someone has to be under for income is so high that everyone falls under the bar, but the amount for over the bar is the same as what is charged to insurances. That way you have set fees, but if you have a cash patient who is ‘under the bar’ you can charge them the lower fees. I know it seems kind of ridiculous, but if you want it to be correct it's the way to go. I hope this is helpful.
Thanks Michele
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