Medical Billing Forum

Payments => Patient Billing => : ellie June 16, 2010, 09:52:35 PM

: DISCOUNT IF PAID IN FULL
: ellie June 16, 2010, 09:52:35 PM
what is the legal way to offer discounts to a patient balance due if they want to pay acct in full ?
: Re: DISCOUNT IF PAID IN FULL
: PMRNC June 17, 2010, 12:40:01 PM
what is the legal way to offer discounts to a patient balance due if they want to pay acct in full ?

That's too vague.. if the patient has insurance than the discount has to be given to both the carrier and the patient which will defeat the purpose ..the insured must meet the cost savings clause of their policy..
If you are talking about a NON insured patient, then the provider can discount to his/her discretion, just make sure the discount is documented both on the encounter and in the chart so that IF there is insurance the provider is unaware of and the patient submits it.. you cover your butt.   If the patient has insurance and the provider does want to discount, they should review their financial policy and if applicable have the patient sign a hardship waiver. It would be against the law to "routinely" discount copay's and out of pocket.
: Re: DISCOUNT IF PAID IN FULL
: ellie June 18, 2010, 12:54:47 AM
thank you for your answer. my manager stated that we cannot discount deductibles but that we could discount coinsurance ?? after insurance paid their portion ??
: Re: DISCOUNT IF PAID IN FULL
: PMRNC June 18, 2010, 12:38:22 PM
No, many office managers and doctors like to decide how the rules work for them  :o  Out of pocket expenses are out of pocket expenses.. deductible, copay, coinsurance are all out of pocket cost sharing obligations of the patient.  If you discount the patient, the insurance company has to be billed with the discount showing. But you can have a discount on a patient by patient basis with a hardship agreement. The hardship agreement should follow what is in your financial office policy and documented in the patient's file.