General Category > General Questions
"Time of Service" Discounts?
PMRNC:
I was referencing cash pay patients only NO insurance at all as that would be completely different. If a provider is taking cash, insurance is non par the provider can provide a cash pay discount but that same discount has to be billed to the insurance. If you want to question that legality, go to any insurance policy booklet under "cost sharing" If a doctor has two patients with same insurance and one pays cash and the other just pays their out of pocket, the doctor has to just make sure he is billing the same fee to both carriers and reporting each payment. A patient's "COST SHARING" is a provision / contractual provision of their policy.
RichardP:
Thanks.
My point was, a doctor or hospital is free to disciminate in pricing except where constrained by state, Federal, or insurance carrier regulations. The point you make is valid. It is an example of a restraint / constraint placed on price discrimination.
And because we bill insurance as a courtesy to those who pay cash but have insurance, we are ensuring that the patient will not try to bill the insurance company for a fee different from what the doctor charged him. This type of billing is a courtesy to the patient, but it is also insurance for us against any sort of snafu developing from leaving the patient to bill on his own.
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