Courting Cash Patients

September 1, 2007

I am considering reaching out to cash patients and to those who are out of network. For example, we would make time slots available for self-pay patients so they would be seen within a week (as opposed to our usual four weeks). And we’d offer a significant discount to them. As for out-of-network patients, our staff responds to such callers with the inevitable: “We don’t take your insurance.” I’m considering bonuses for staffers for every self-pay patient they schedule. Does this sound viable?

Question: I am considering reaching out to cash patients and to those who are out of network. For example, we would make time slots available for self-pay patients so they would be seen within a week (as opposed to our usual four weeks). And we’d offer a significant discount to them. As for out-of-network patients, our staff responds to such callers with the inevitable: “We don’t take your insurance.” I’m considering bonuses for staffers for every self-pay patient they schedule. Does this sound viable?

Answer: It is viable. Here are some things to consider:

Write a set policy on charges for cash patients (whether they will file their own insurance later or not). You don’t want to charge individuals differently, lest you be accused of discrimination. This should also make it clear that the charge is a discount for payment at the time of service, not your usual and customary charge.

As far as a staff incentive, I’m not sure you need it. You might just try training them first and explaining why this is better for the practice. Teach them to fully inform the patient: “We don’t contract with that payer, but we are happy to see you on a cash-only basis. I can schedule you now. We will expect payment at the time of visit, so bring a credit card or checkbook with you. In exchange for your prompt payment, you will get a discount from our usual fees. We will also hand you the paperwork you’ll need to bill your managed care company yourself after your visit, if you wish. They may not reimburse you for the full cost of your care.” Something like that. Give them a script and make it very clear to patients that they will pay at their visit and that you will not be filing their claims.