Compliant self pay billing

Sdbrown26

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I am looking for information on compliant billing for self pay. Is it appropriate/compliant to bill a patient that is self pay a different fee than what is on our fee schedule for insurance payers? Can anyone direct me on the best place to find information on this subject?
 

mitchellde

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It is not wholly compliant to charge the self pay a different fee from the insured. Remember in addition to the copay you’re insured population must pay a monthly fee for the privilege of being insured and the self pay do not pay this each month. So to offer a reduced rate is adding an incentive to be uninsured. Just something to think about. You can have a plan for those that cannot a ford insurance and do not qualify for Medicaid, and each state has qualifications for this and you need a method of making sure this is met. What you don’t want is some one that could be insured but chooses not to because it is cheaper due to special self pay rates.
 
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