Are we allowed to reduce charges for patients with high deductible?

[Guest guest]

Can I ask what your fee is in comparison to the $90 allowed by

BCBS that got applied to the deductible. What I tell patients is that

this is already discounted below my normal rates and that this is what BCBS

says they owe. If you charge less that that contracted amount you could

get in trouble and they could reduce your rate to that which you accepted for

all BCBS patients.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Dr Levin

Sent: Wednesday, May 05, 2010 10:19 PM

To:

Subject: Re: Are we allowed to reduce charges for

patients with high deductble?

Don't

discount below Medicare discount rate -- I give prompt pay discount (AFTER

applied to deductible) of 10% once the bill goes through.

Give

credit for the full payment toward the deductible; but take " payment in

full " at a % above medicare rates and you'll be ok........so my billing

company tells me.

Matt

in Western PA

PS

if you discount BELOW Medicare rate, you can get in trouble.

Do

NOT wave copays.

-----

Original Message -----

From: Helen Yang

To: practiceimprovement1

Sent: Wednesday, May 05,

2010 9:31 PM

Subject:

Are we allowed to reduce charges for patients with high

deductble?

Some of my patients have high dedubtble plans with BCBS. A few of them always

refuse to pay anything at the time of service even when they know they have not

met their deductble yet. When we bill these patients after getting the EOB, one

is asking me to discount the charge set at BCBS fee schedule.

Are we allowed to discount this charge? If BCBS record shows $90 dollars

toward his deductble while I only collect $60 from him, would this be

considered insurnace fraud? If this discount is allowed, are we obligated to

offer similar discount to all of the patients?

Thank you very much in adavnce.

Helen

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