Author Topic: Insurance Fee Schedule/Self Pay Fee schedule  (Read 10734 times)

mforgione

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Insurance Fee Schedule/Self Pay Fee schedule
« on: August 01, 2012, 09:27:35 PM »
Question: My clients (client 1) bill to insurance a set fee schedule. They charge their patients who do not have insurance or who have insurance for which they do not par with the same rate...however, since it is the same price (self pay and insurance rate)it seems legit to me...I have another client who bills out services to the insurance company at one rate which is coded appropriately and for self pay patients she states ie, 99205 is 275-she calls this a new patient visit and a 99214 is 150 and she calls this a follow up.
If she makes the financial hardship income $250,000 can she (second client I mentioned) do a sliding scale for patients? Does she have to have this policy written up in a handbook? The second client stated that she felt she can charge cash patients whatever she wanted. I read some other posts in the forum and am slightly confused now.
Please advise

DMK

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #1 on: August 02, 2012, 11:29:17 AM »
Financial policies should absolutely be written up and strictly adhered to.  There should be a set rate for patient pay and a policy for hardship.  It should NOT be different rates for different people.

Patient's do get frustrated when they change insurance and their portion changes.  Blue Cross pays much less to contracted providers than Blue Shield does.  So if the patient has a high deductible, they end up paying a lot more out of pocket and they want to know why.  It's a hard discussion.  It's easier, though, when they present their card and you tell them right up front what they can expect to pay out of pocket.  Then there's no surprises.

sandyb52

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #2 on: August 03, 2012, 03:10:21 AM »
Do I understand correctly that it is ok to charge self-pay patients a certain amount that is lower/different than that charged an insurance?

DMK

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #3 on: August 03, 2012, 10:16:57 AM »
You can have a cash discount.  You should still enter the SAME charges as your insurance fee schedule (which should be them same rate you charge ALL insurance other than worker's comp), then have a line item showing the cash discount.

mforgione

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #4 on: August 03, 2012, 12:34:26 PM »
Thank you! :)

sandyb52

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #5 on: August 03, 2012, 01:40:37 PM »
Thank you soooo much!

Michele

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #6 on: October 22, 2012, 11:27:40 AM »
Huh?
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PMRNC

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #7 on: October 22, 2012, 03:46:29 PM »
Quote
Huh?

Quote
If she creates the economical problems earnings $250,000 can she (second customer I mentioned) do a moving range for patients? Does she have to have this plan published up in a handbook? The second customer described that she sensed she can cost money sufferers whatever she desired. I study some other content in the community and am a little bit puzzled now.

Double HUH???
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rdmoore2003

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #8 on: October 22, 2012, 03:48:49 PM »
I know its Monday, but I have read all the posts for this, and I guess my reply is:

TRIPLE HUH????
Regina

DMK

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #9 on: October 22, 2012, 06:26:41 PM »
Seems like something is being lost in the translation!  So I see your Huh? and raise you!

Michele

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #10 on: October 23, 2012, 07:53:18 AM »
Glad to see I'm not losing my mind.  I almost deleted it but thought "maybe I'm missing something??"
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supertaz93

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #11 on: October 24, 2012, 07:00:11 AM »
You just posted the same thing that none of us understood above.  So once again, HUH?

DMK

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #12 on: October 24, 2012, 10:22:57 AM »
Since John Smith can't spell John correctly, I think we're being scammed. "Varicose veins phoenix"  ???

rdmoore2003

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #13 on: October 24, 2012, 02:09:58 PM »
He is wasting our time.  None of this is understandable.   Michelle, I vote to remove his posts.
Regina

PMRNC

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Re: Insurance Fee Schedule/Self Pay Fee schedule
« Reply #14 on: October 24, 2012, 06:26:43 PM »
All in favor say "HUH"  :)
Linda Walker
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