Wiki Different Self Pay Rates

[arieljones1995@gmail.com]

Hi guys!

So it seems my boss is in the business of offering a different self pay rate to patient's that have transferred over from his old practice. We are a physical therapy office, and our rate at our practice is about about 45 bucks more for each visit than at his old practice. He is giving the old practice rate to transferring patients (so a discount of 45 bucks each appt) - this has to be illegal, correct? What can I cite to him to get him to stop giving these patients discounts?

And just to be clear, he can treat them for free, correct? Just not give them a discount? Any help is appreciated!

 

[brockli2020]

I am needing an answer on this similar issue...you can't charge different amounts to different patients for the same charge when they are both SELF PAY, right?

 

[csperoni]

I am needing an answer on this similar issue...you can't charge different amounts to different patients for the same charge when they are both SELF PAY, right?

You can only charge different amounts if you have an established financial hardship policy, and have evaluated that a particular patient qualifies for your policy's definition of financial hardship.
If your rate for 99213 is $250 and you offer a 50% cash discount for anyone paying the day of service, then both patients who receive 99213 services should be charged $125 absent financial hardship. Don't forget you should also be providing these patients with estimates when scheduling with the No Surprises Act.