Charging Less Than Medicare
Can we legally charge our self-pay patients less than what the Medicare fee schedule allows?
Question: Can we legally charge our self-pay patients less than what the Medicare fee schedule allows?
Answer: Ask 10 managers this question, and you’ll get 10 answers. It’s a gray area. Here’s my answer: Yes, you can charge self-pay patients less than Medicare, but you want to make it clear that this lower charge is not your “usual and customary fee” (lest Medicare decides to pay you that much, too). So, you might offer it only to self-pay patients who pay in full at the time of service since there are obvious cost savings to you. Or you might reconsider the lower fee if self-pay patients make up a sizeable portion of your patient base. If you do it, do it judiciously.
Health care’s 2025 revenue cycle imperative: Reduce administrative waste
January 22nd 2025Given that so much of the high costs associated with running a healthcare business remains outside of the organization’s control, financial leaders will have to consider how they can impact the one area that is in their control in 2025: reducing administrative waste.
