Using a Sliding Fee Scale: Some Do's and Don'ts

by Legal and Regulatory Affairs Staff

From time to time, practitioners encounter clients who are unable to afford the services they need. Many practitioners faced with this situation consider reducing their fee on a “sliding scale” basis. Doing do may carry significant legal risk if not instituted correctly.

Following are several pointers for practitioners on what to do and what not to do.

Do follow your managed care contract.

You cannot charge an insured client less (or more) than you have contractually agreed to with his or her managed care company. The vast majority of managed care contracts prohibit practitioners from waiving or reducing copayments or deductibles. If this issue is covered in your contract, you must contact the managed care company for permission to waive or reduce the copayment or deductible. Unfortunately, this interaction is likely to be a complicated and time-consuming endeavor.

Do create a paper trail…