Cash-only fee schedule

[Path2009]

Does anyone have experience with cash-only fee schedules for pathology - separate from charges for insurers and medicare/medicaid? I have been told that they are legal, with the rationale being that the collection overhead is completely different. For example, charging the medicare rate for cash patients. The finance consultant at my hospital tells me that this is illegal and that we are only allowed to have one charge per CPT code. Historically, our rates have been high to capture on our commercial contracts which are a % of charges billed. But it really hurts the cash patients. Thoughts?

---

Members don't see this ad.

 

[AZpath]

Does anyone have experience with cash-only fee schedules for pathology - separate from charges for insurers and medicare/medicaid? I have been told that they are legal, with the rationale being that the collection overhead is completely different. For example, charging the medicare rate for cash patients. The finance consultant at my hospital tells me that this is illegal and that we are only allowed to have one charge per CPT code. Historically, our rates have been high to capture on our commercial contracts which are a % of charges billed. But it really hurts the cash patients. Thoughts?

Your hospital needs better advisors. It is legal.

Your cash price is merely a discount from your standard billed charge. Typically this is offered to patients without insurance. Hospitals and other organizations are starting do more cash pricing for a few individuals with insurance. This is mostly as a result of high deductibles and narrow networks.

 

[stickyshift]

I would love to get cash up front for everything I do. Imagine not having to go through insurance or billing companies anymore!

 

[Path2009]

Your hospital needs better advisors. It is legal.

Your cash price is merely a discount from your standard billed charge. Typically this is offered to patients without insurance. Hospitals and other organizations are starting do more cash pricing for a few individuals with insurance. This is mostly as a result of high deductibles and narrow networks.

AZpath - We also do a discount off of our standard billed charge. It comes in around 30% off. But that is still a large sum because many of our sticker prices are so high (due to the % of billed charges situation with commercial insurances). What I'm looking for is a cash-only fee schedule completely separate from other fee schedules, and is about medicare rate.