1. Professional courtesy. It is legal to provide courtesy to physicians in the community, their families and their staff, generally speaking. However, it becomes illegal is when courtesy targets physicians or people who are in a position to refer federally-insured patients to the practice.
2. Waiving co-pays or accepting “insurance only” as payment. Patient co-pay waivers are generally illegal and certain states have deemed “insurance only” billing as fraud. There is however, one limited exception to the prohibition of co-pay waivers — a waiver based on demonstrated financial hardship. Practices must determine a process in terms of what patients need to provide to qualify for this exemption.
3. Discounts for cash payment. The practice of bypassing insurance is legal, but anesthesiologists need to check whether undercutting their own negotiated rates violates any of their health plan contracts.
More articles on anesthesia:
Federal Court of Appeals rules against CMS in overpayments case: 5 insights for anesthesiologists
Cross Keys Capital plays integral role in MEDNAX, Westchester Anesthesiologists merger: 5 key points
Dr. Dawn Desiderio joins International Association of HealthCare Professionals: 3 points
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
