jbrice1639 said:
actually, you cannot. if you have a practice, you must have established charges for your services that have to be the same across the board. you cannot just decide to waive a fee. you cannot even waive someone's co-pay legally.
You certainly can be lax in sending out bills and deciding whether to send to collection. Happens all the time.
edit: actually, you may be wrong on the issue, at least on some points:
Waiving Co-Pays
The most common ways physicians reduce the cost of care for patients are waiving the co-pay ("insurance only") and giving the patient a discount on the care. In most situations, both private insurers and the federal government ban waiving the co-pay. (Medicare has some provisions allowing the co-pay to be waived for documented indigency.) They do this because the co-pay is meant to discourage casual trips to the physician. The theory is that making the patient share the cost of treatment will make the patient a more sophisticated health care consumer. The reality is that the co-pay limits access to care for many people. The less care the patient seeks, the less money the health plan has to pay to physicians and hospitals for that care. Both private insurers and Medicare require the physician to make reasonable efforts to collect co-pays that are billed to the patient.
Discounts
A discount is a reduction in the normal charge based on a specific amount of money or a percentage of the charge.
Just as the hardware store can give you $5 off on all tools or a 10% discount on your total purchase, a physician may take $5 off or 10% off of the bill for an office visit or a surgery. However, there are things that the physician must beware of in doing this. The discount must apply to the total bill, not just the part that is paid by the patient. If the patient owes a 20% co-pay on a $25 charge ($5) and you are giving a discount of $5 then the patient pays $4 and the insurance company pays $16. If the patient owes a $5 co-pay regardless of the amount of the charge then the patient must pay $5 and the insurance company pays $15. In this situation, the discount would only benefit the insurance company.
Discounts raise the issue of the physicians customary charges for a procedure. Many private insurance plans and some federal programs have a "most favored nation" clause in the contract with the physician. This entitles the plan to pay the lowest charge the physician bills to anyone. Any systematic pattern of discounts could trigger a reduction in the physicians allowable reimbursement schedule to the discounted price.
"No Charge"
As far as the authors have determined, none of the private insurers bans waiving the entire charge for the care. You may also charge for some visits and not for others. Many pediatricians do not charge for the first follow-up visit for otitis media. This increases the likelihood that the child will be brought back for the recheck The insurance company is also getting a free visit, but at least the patient is getting the care.
"No charge" visits are prohibited if they are part of a fraudulent scheme. For example, a no charge visit is still a patient care encounter and must be fully documented. Assume that a patient has severe asthma and is waiting out a one year preexisting illness exclusion in a health insurance policy. If that patient requires treatment a month before the end of the year waiting period, you have to fully document the treatment even if you do not charge the insurance company for it. You cannot use "no charge" to hide medical information.
You may also deliver non-reimbursable care as part of an otherwise justified office visit and bill the company for the authorized part of the visit. For example, if the insurance doesn't cover immunizations, then you could do the immunizations at the time you do an authorized well-child check up, or when the child is in for some other medical condition that is not a contra-indication for immunizations. You cannot, however, bill for an office visit when the only reason the patient is being seen is to deliver care that is not authorized under the policy. It would also be improper to "no charge" as a way to waive a co-pay in order to generate ancillary business for the physicians office lab or other health services business. In other words, you cannot no charge for the visit and bill the insurance company for $100 worth of lab work that it would not have approved as part of a reimbursed visit.
http://biotech.law.lsu.edu/Articles/Professional_Courtesy.html
