Wiki Different fee charges for different insurances?

[pvacanti]

Some physicians in my office are saying that "It is illegal for us to have different charges in place for different insurance carriers". I have looked online but am getting conflicting information. Does anyone have any information about whether this is true or not and if so where can I find it? Thank you!!!

 

[LexyKline]

Some physicians in my office are saying that "It is illegal for us to have different charges in place for different insurance carriers". I have looked online but am getting conflicting information. Does anyone have any information about whether this is true or not and if so where can I find it? Thank you!!!

I have always been taught this but I am struggling to find any hard evidence. Were you able to find evidence of this?

 

[SharonCollachi]

It is not "illegal" in the sense that it is prohibited by law, it is just a "Very, Very Bad Idea." (Heck, it may even be in the Medicare regs somewhere that you cannot charge them more than you charge someone else - I don't have the time to research that)

Look at your contracts... most will say you cannot charge them less than you charge anyone else.

Look at Medicare... if Medicare finds you are charging a commercial insurance less than them, then they will ask for refunds of the amount you overcharged Medicare (a very simple way of putting a very complex process).