Practice Management Alert

Question: Last month I read your article about having a financial hardship policy. The article advised against routinely waiving copayments or offering discounts to patients with Medicare or other insurance. Should we apply the same rules about discounts and not waiving fees to how we deal with financial hardships with uninsured patients or those who have insurance that our practice doesn't participate with?

New Hampshire Subscriber

Answer: You are not required to charge your full fee to all of your patients that do not have insurance. You can offer a prompt payment discount when your patients pay right at the time of service. In other words, you can offer the patient who has no insurance a discount that can be as low as or even below what you accept from private payers if they pay you on the date of service, to help them out with the financial burden of not having insurance.

Caveat: Be aware that you need to offer this same discount to third-party payers as well. Make sure you are not offering a bigger discount to your uninsured patient than you are offering the insurance carriers you work with. Rarely, if ever, will a payer pay at the time of service, however.

How it works: Patients have to pay with cash, check, or credit card on or before the date of service to receive the discount. Do not write off the difference between the normal fee and the discounted rate until you receive payment. This way other payers cannot complain since you are willing to offer the same prompt pay deal to them.

Pointer: When the patient pays you, do not put CPT and ICD-9 codes on the receipt you give to the patient. That way, should the patient actually have insurance, he cannot submit the bill to his insurance company and get reimbursed equal to or more than you were paid. Additionally, he cannot get you in trouble for not following a contract with an insurance company. If the patient wants a claim to submit to the insurance company, tell him you would be willing to submit a claim, but you will have to submit full fees and you must then charge the patient copayments or co-insurance and your discussion based on being uninsured does not apply.