Amount charged for insurance pay clients vs. cash pay clients

by Kim

I was always told that there can be a minor difference in the fee charged to a cash paying client vs. an insurance paying client. The doctor I work for doesn't believe me and wants written proof that you cannot charge one client $150 and another $50 (examples)for the same service.

I need guidance on where to find this or for someone to tell me I have lost my mind and there are not guidelines for the fee scale question I have.


It may not be a simple answer. My understanding is that it can depend on the laws in your state and/or the contract(s) your provider has with any insurance companies that he is in network with.

Here's a good article that discusses the legalities of cash pay pricing while still in network.

Hope this helps answer your question. I encourage comments (click on link below) by any of our visitors who have dealt with this issue.


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