Patient Discounts

February 1, 2006

I have a sleep lab, and I want to charge patients different prices depending on whether they are self-pay or if they don't want to pay coinsurance or a high deductible. Can I do this?

Question: I have a sleep lab, and I want to charge patients different prices depending on whether they are self-pay or if they don't want to pay coinsurance or a high deductible. Can I do this?

Answer: If patients are strictly self-pay, you can offer a discount. What you'll want to do is create a written policy for staff to follow and that you can distribute to patients. It might say, for example, that anyone who is self-pay (that is, has no insurance), and who pays at the time of service, can have a 20 percent discount based on your standard fee schedule. Make sure that the policy is used consistently. You don't want to offer the discount to one patient, but not another.

You should not reduce your prices any lower than your lowest allowable, lest this new price be perceived as your reasonable and customary fee.

It's a totally different story for patients who are insured but have a high copay or deductible. You must collect all of the money they owe you - all of their copay or deductible, according to the contracts both you and the patient have with the insurance company. If the patients don't like to pay the high deductible or copay, they should find a new plan with a lower deductible or copay.