No, not after the fact. The logic being that the insurance carrier would be paying on a different amount. For example if the patient has a $100 out of pocket balance due on a $500 charge billed to the insurance, if you discount, say $50.00 then there has been a breach of contract between the patient and the insurance company because they too should have the opportunity to pay the charge based on the discounted fee ($450, using my example). That's ONE issue. The other issue is the Anti-kickback statute which says "doctors may not routinely waive copay's and out of pocket....etc etc" The concept being that IF you know in advance there is a hardship, then a hardship agreement should be in place and again it cannot be done "routinely".