# Discounts for self pay patients



## Jfrank (Apr 21, 2010)

I'm not exactly sure how to word this...
Can a physician give discounts to uninsured patients "legally" as long as the fee schedule for self pay and insurred patients is the same?
Example:

An insured pt gets a holter monitor for a fee of 410.00, but the fee schedule
with the insurance is, say 210.00. The insurance says to adjust off 200.00, then pays the 210.00 and the patient has a $0 balance. 
Can a physician do this same adjustment for a self pay patient. Billing the 410.00, but releasing only the 210.00 to the pt and giving a 200.00 "discount"?

It's a discussion we are having in our office, and there are varrying opinions. If there is a website that spells this out, that would be extremely helpful.

Thank You


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## kmhall (Apr 21, 2010)

*Discounts for uninsured*

Here is a link from CMS that might be helpful:

http://www.cms.gov/AcuteInpatientPPS/downloads/FAQ_Uninsured.pdf


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## JMeggett (Apr 21, 2010)

It's my understanding that as long as your practice has a policy set in place to treat all selfpay patients the same, it is absolutely ok.  Some practices always discount 10% when patient pays on same day.  Or you could do a set dollar amount adjustment...as long as each selfpay patient is treated equally.  If a patient is insured by an insurance that your Provider is contracted with....that's when things get strict.

Jenna


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## Jfrank (Apr 22, 2010)

Very Helpful, Thank You.


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