Self-Pay Discounts

June 1, 2005

What has been your experience with practices offering discounts to self-pay patients? They are the only ones paying full price and the ones who can least afford it. How do practices manage this?

Question: What has been your experience with practices offering discounts to self-pay patients? They are the only ones paying full price and the ones who can least afford it. How do practices manage this?

Answer: Most practices seem to offer an across-the-board discount to self-pay patients if payment is in full at the time of service. The discounts range from 10 percent to 30 percent. You certainly could write a policy that says the discount applies if people pay at least half up front and take with them an envelope and invoice for the other half due in 30 days. Your billing costs are low and it makes sense.

Many also have a discount policy or sliding scale for poor patients. You can base this on poverty levels in your region. See www.ocpp.org/poverty.

You are allowed to offer discounts, but because you don't want payers to see this as your "usual and customary" fee, you should not go below your lowest discounted rate or below Medicare.

You also should have a written policy on any discounts, and follow it to the letter. You can't have patients claiming that you treat some preferentially.