Can I legally and ethically bill the patient for
less than what I would bill Medicare?
I have an example that isn't the exact same situation but may be helpful.
My chiropractor has a special "cash" patient rate of $40 per visit, which
covers everything he does and every modality he uses during a particular
session. The same session billed to insurance would include separate
charges for each technique and modality and might be, for example, $80.
With cash patients, he doesn't have to bother with extra paperwork and
filing with insurance, and he also receives payment immediately, so a
discount for patients paying cash is appropriate. Also, he doesn't
necessarily receive the full billed amount from insurance companies -- he
only receives the contracted rate. So, perhaps he would receive $50 from a
patient's insurance company but $40 from a patient with no insurance. It
doesn't end up being much of a difference.
I actually have insurance coverage for chiropractic, but it ends up being a
better deal for me to just pay cash! : )
Hope this helps you. In short, I say yes, it would be legal, ethical and
appropriate to bill this patient less for cash services for several reasons.
: )
~Wendy B. (MS,OTR)
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