Our company offers a courtesy / cash discount on self pay balances if paid at the time of service. The discount is offered to reduce billing costs and in consideration of the time value of money.One of our patients is paying their bill, receiving the discount and apparently billing their insurance themselves and collecting more than they ultimately paid us. The physicians at the site think this is ok. Can anyone give me something I can use to support my position that this is not ok? Let me extend the question: is it legal to offer a cash discount on deductible/co-pay/non covered balances to patients with insurance as opposed purely to patients that are solely self pay?Thanks. I"m confused.....1. if it is self pay then how are they filing insurance???2. Are you having them pay up front because you are non-par? If so you should be billing non-assigned and having the patient recieve the payment.3. Is this the copay deductible then yes if you are a participating provider, you have a legal contract that states that you are in network and must collect the patients coinsurance. This looks like a "kick back".
* Let's say it is a self pay patient and the bill for today's visit is $100. We would provide a cash / prompt pay discount of 10% if they paid at the time of service.
* What if it is an insured patient who owes $100 for their co-pay and non covered services? Can the same 10% discount be applied as a collection tool to get cash upfront and avoid collection costs? I am not talking about waiving the co-pay just discounting it for immediate payment.
* We do not participate with the carrier in question and we are not submitting a claim to the carrier.
* It is my understanding that the patient is using claim forms the office is providing to the patient.
* When I refer to self pay I am referring to self pay balances whether they be from non-insured patients or balances owed from patients with insurance.
* Are we able to discount the co-pay as a means to collect the balance at the time of service eliminating the need to bill the patient and make collection calls? This is a discount not a waiver of the co-pay. I read several sources saying the OIG has ok'd discounting as a means to avoid collection costs.
* In an internet search I found a number of hospitals / offices that post their policies on-line. it seemed a split as some specifically referring to discounts for the uninsured and others just referring to discounts on cash payments.
At our office we have one particular insurance company that we know does not pay for routine office visits. Thus, we discount the visit to our spp fee of $60 when we bill the insurance - thus the patient will not be responsible for more than $60. It is my understanding that as long as you are billing the same amount to insurance as you would provide a patient statement for (whether it is the full $60 or discounted by insurance) that it is legal.
However, I also thought it was legal to write off old account balances that have not been paid as a means to eliminate collection costs for the practice.
Also . . what do you do in the scenario where a patient realizes that they have an extremely high deductible and it would be cheaper to pay the self pay patient rate, rather than to bill their insurance. Can you allow them to choose to pay self pay and NOT file the insurance?
however what do you do for the patients that present and lie stating that they do not have any insurance - just so they can get the cheaper rate?Anyone got any ideas? Huh