Perhaps your practice has had success charging for no-shows or sports physical form completions—or maybe you’re just starting to investigate which administrative fees you might explore. Either way, there are many factors to consider if you’re thinking of charging administrative fees, but before you dot your I’s and cross your T’s, you might want to check out a comprehensive roundup of the fees that some practices have had success charging.
Check out five administrative fee options before deciding which might be right for your practice.
1. No-Show Fees
Many practices charge patients when they fail to present for an appointment. Keep in mind, however, that Medicare and many other payers include a catch in their no-show fee rule: You must have a written policy in place outlining your no-show policy, and the fees must apply uniformly to all patients.
In addition, you can never charge Medicare or most other insurers for the fee. That should be billed directly to the patient. Make sure you create a no-show policy that patients sign as part of their financial agreement when they join your practice so they’ll know about the fee ahead of time.
Caveat: Unlike Medicare, Medicaid typically prohibits no-show fees, so always check your payer and state rules before charging these fees.
2. Medical Record Copy Fees
Whether patients request electronic medical record copies or hard copies, most payers allow you to charge a fee for making those copies, but you have to follow state laws, as well as insurer requirements, before you create your policy. You’ll usually face limits or maximums on what you can charge to patients, and some payers may be very specific about how you tally these fees.
When patients ask for copies of medical records, always follow your written fee schedule for these services, and update it frequently to ensure you’re complying with all laws and payer requirements.
3. Prescription Refills
When patients need prescription refills but don’t have an in-person or telemedicine visit, some practices charge an administrative fee to call in the refill. If you’re thinking about charging for this, keep in mind that if you accept insurance and what you’re actually providing could be considered medication management, the insurer will likely expect you to bill for it and document it, since that’s often a covered service.
However, a true prescription refill is different from medication management, so if you’re simply doing a prescription refill, many states will allow you to charge a fee for that. Check with your payers and state laws to ensure they don’t have restrictions on these fees.
4. Completing Forms
Every practice is likely to get requests to complete forms, whether they’re for school sports physicals, FMLA, life insurance, disability or other reasons. In most states, it’s acceptable to charge an administrative fee for the time spent filling out the form by you and your staff, as long as the insurer doesn’t restrict it.
5. Faxing Documents
Much like completing forms, faxing documents takes time out of your day, so if a patient asks you to send documents to their employer, school, life insurance firm or other locations, you may be able to charge a fee for this time, as long as state law and insurers allow it.
Get Everything in Writing
Before charting administrative fees, make sure you have written policies in place, that your entire staff is aware of the policies, and that patients have signed off on them with their initial financial paperwork. In addition, cross-reference your fee plans against your payer contracts and state law rules to stay compliant.
Interested in getting more tips on fees your practice can charge? Watch as healthcare attorney Amanda Waesch, Esq., leads you through the ins and outs of the rules around this topic. During her one-hour online training, “Get Paid More With Patient Cash-Only Services & Comply With Payer Rules,” Amanda will give you the step-by-step tips you’ll need to ensure you’re checking all the legal boxes when you charge administrative fees.
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