January 8th, 2015
All healthcare providers need to be aware that there are both appropriate and inappropriate ways to discount your fees. Both state and federal laws can impact your practice financial policy regarding fee discounts. Additionally, we recommend carefully reviewing Chapter 1 - Insurance & Reimbursement of the DeskBook for important information on fee schedules and discounts. Note: Prior to 2016 you will find it in Section F-Fees of the DeskBook.
Different types of healthcare discount programs are available in the market today and providers need to understand that discount programs are NOT health insurance. Not all discount programs are created equal. Some are not completely legitimate.
Before signing up; Carefully evaluate Healthcare Discount Programs by asking the following questions:
- Are they properly registered, approved or licensed if required in your state and do they meet all state regulations?
- What are the enrollment costs/fees? The costs for either the provider and/or the patient might not balance out any benefits.
- What are the provider's renewal and cancellation fees? Do you have the ability to opt-out at any time?
- Do they offer refunds as required by state regulations? If so, what are those refund policies for both the patient and the provider?
- What does the BBB say about them? Not every business has a BBB rating, but if they have complaints, that could be a red flag.
- What about Medicare? If you see patients over age 65, you need to be aware of all Medicare rules and regulations and how this plan affects your Medicare patients and your practice billing policies.
- Is the plan owned by an insurance carrier? Could they use your participation in the plan to remove chiropractic services as a covered benefit?
- Are the discounts set by the plan or do the providers have the options to choose the level of discounts and services that will be discounted?
- Does the plan have the ability to "sell or rent" your name creating silent PPO activity?
TIP: Do your homework before signing up for anything. If you exercise proper due diligence, you can avoid "buyers remorse."
ChiroHealth USA is a reputable discount program for chiropractic services that is available in most states and endorsed by ChiroCode Institute and some other professional organizations. It is a unique network concept that helps doctors and patients enjoy the benefits of compliant discounted fees. Functionally, it is a network that is dedicated to doctors and patients. is registered as a discounted medical plan in most states. This network supports the
- CLICK HERE to read more about avoiding Medicare and Medicaid Fraud and Abuse by the OIG.
- ChiroHealth USA