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Uninsured and Indigent Patients

Topic: Uninsured Patients

Sponsor: Corcoran Consulting Group

Updated: 02/22/2022

Corcoran Consulting Group

Use your regular fee schedule for all patients.  Do not assume that uninsured necessarily means indigent.

Best practices indicate that a single fee schedule is preferred over multiple fee schedules. More than one fee schedule creates patient animosity and potential legal liability under federal and state laws.

A discount for self-pay is fair and reasonable when:

  • a claim does not need to be submitted to a third party payer, thereby reflecting the lower cost of billing and collections, and
  • the patient pays at the time of service.

Furthermore, prompt payment reduces the potential cost of bad debt.  An additional discount for indigency is discussed below.

This FAQ addresses the following:

  1. How do I establish fees for uninsured patients?
  2. May I give a discount to uninsured patients?
  3. What is a reasonable discount for payment at the time of service?
  4. Is a 10% discount for prompt payment reasonable?
  5. May I discount my charge for uninsured, indigent patients?
  6. How do I provide a discount for care to uninsured, indigent patients for an extended period of time?
  7. What is the maximum discount that may be given to an uninsured, indigent patient?
  8. May I demand payment in advance from an uninsured or indigent patient?
  9. If a patient doesn’t pay for the care, must we send him to collections?
  10. What should I do if a patient subsequently provides evidence of insurance?