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Thread: self pay patients - The physicians

  1. #1
    Join Date
    Apr 2007
    Harrisburg, PA

    Default self pay patients - The physicians

    AAPC: Back to School
    I am just questioning what the rules are for self-pay patients? We have a patient who lost his insurance, but would like to follow up with the recommended tests that his physician ordered. He was ordered for a nuclear stress test, an echo, and a holter monitor as well as labs. The physicians would like to be able to extend him some courtesy in the form of writting off some of his bill (not the entire thing, just a small portion). I was informed that this is not allowed by an outside source because he is not of Medicare age. Although this person could not back up their statement with proof, I would like to let my physicians know if this is okay to do or not.

    please someone help me out!

    Thank you in advance!

  2. #2
    Join Date
    Apr 2007

    Default Self pay patients....

    I work for a family medicine physician and we often see patients who are private pay and we often provide a self pay courtesy discount which is totally allowed because we are not filing a claim or anything. We also perform in office stress testing, lab studies and a few other in office procedures and for private/self pay, we do give a 20% discount on the services. We mostly pay client prices for ordered lab test through the contracted labs which are inexpensive for us and therefore, we compare the client price to the patient price and negotiate an amount to collect from the patient. I do believe this is OK...it's the physicians discretion....hope this helps.

  3. #3
    Join Date
    Apr 2007
    South Miami

    Default Office Policies and Procedures rule over the self-pay patients

    Doctors are allow to give his own quotes for self-pay patients

    If a test is $100.00 and the Doctor want's to charge only $25.00 or $50.00 is Ok
    you need to document the visit as Self-pay service quoted at X amount

    For Medicare, Medicaid patient's (CMS) and the State don't allow to write off any amounts if those are applied as Deductible and/or Co-insurance.

    Your doctor can make an overall quote for all services and work a payment plan.
    Even if he wants to give his services for free and charge only the Technical component of the test.

    My surgeon does some charity cases and the patient only pays for Facility or Technical componen of the test.

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