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2017 July Newsletter
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Establishing a Professional Fee Schedule
Jeff Clark, ND | OANP Legislative Committee Chair

Preface by Laura Farr: Many ND clinics have been contacted by “secret shoppers” paid for by insurers asking what the fee schedule is for insurance and for cash paying patients, then adjusting reimbursement rates accordingly. It is ok to offer a discount for paying cash at the time of service, but please remember that you should only have ONE fee schedule. Be careful to train your office staff to respond to questions appropriately that your office only has one fee schedule even if you offer a discount for cash payments at time of service. 

There are a number of business related topics that you just don’t have the ability to understand properly while you are in your medical training program. One essential topic is establishing a professional fee schedule. There are conflicting goals in setting fees that need to be carefully considered. You want to charge enough so that you minimally meet the financial needs to operate your business, properly pay your staff, and yourself, for your labors. In order to achieve this you need to be billing high enough to capture all of the available reimbursement from every payer. Insurers pay the lesser of what you ask for, and what their contract says they will pay. If you expect people to self-pay, your fee also needs to be at an accessible price that people can afford.
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