Wiki Separate Fee Schedule for Auto Payers

[pmogel]

I have a physician that wants to set up a separate fee schedule for the auto insurance payers (higher rate) than she has for her private pay and contracted carriers. Her reasoning is that there are no contracts involved. I know that a physician cannot have a separate fee schedule for private pay patients than they do for the payers. And I don't think she can have a separate one for the auto payers.

Does anyone know where I can find information to confirm this? I need to be able to give her hard facts, not just my opinion.

Thanks,
Patty, CPC
Arizona

 

[mitchellde]

Auto payers like work comp are non HIPAA and therefore yes you can have a higher fee schedule for them.

 

[pmogel]

Thanks for clarification.

 

[bhaugh]

Thanks for clarification.

I would check to make sure by doing so, she is NOT in violation with any price gouging laws. Also just because auto insurance may seem like a non contracted entity, most will rent networks from which you may be contracted and you will still be required to take an adjustment. Before automatically accepting an auto plan know who they price claims from and if a contracted carrier, contact the auto carrier directly and advise you will not accept discounting a bill.

Barbara