Cash Patients And Dual Fee Schedules
If your website says “$20 for massage” and you charge insurance companies $40 then you have a DUAL FEE SCHEDULE!
If you tell cash patients “electric stimulation is $20” and you charge insurance companies $30 then you have a DUAL FEE SCHEDULE!
If anyone who calls your office and asks how much you charge for an adjustment and your staff tells them “we charge $40 for an adjustment” and you charge insurance companies $55 then you have a DUAL FEE SCHEDULE!
The above scenarios happen every day at chiropractic offices. I know because I represent chiropractors all over Florida. Please make sure that you know the laws to avoid getting into trouble with your license.
Here Is The Law:
You must bill everyone the same amount. BUT you can accept less money in payment.For example, let’s say you sent a bill for an adjustment to Medicare, to Health, and to PIP. Your CMS 1500 form (your bill) will show the same charge. Medicare, Health, and PIP will all send you a check for different amounts. THAT IS OK! That is not a dual fee schedule.
The dual fee schedule only affects how much you charge…not what you accept as payment!
Similarly, when you have a cash patient you need to hand them a bill for the same amount as you would bill Medicare, Health, and PIP. But you can tell the cash patient that you will accept less money as payment. Never tell someone over the phone that you will “charge” them “X” when you normally bill “Y”! You never know who is on the other end of that phone! That could cause trouble for your license!