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Charging for Admin time

           June 17, 2015
 
Question:

Hi Jennifer,

Patients often ask us to fill out disability forms and other applications/documents.  For example, we have been requested to complete New York State Office of Temporary and Disability Assistance Division of Disability Determination forms for a patient.  Can we charge the patient a $25 fee to fill out these forms even though New York State pays the doctor a $10 fee? Also, in general, are we allowed to charge fees to complete state/city forms in order for patients to obtain benefits from the city or state?

Thanks, 
Dr. L

Answer:

Certain states regulate charges from providers for patient paperwork, NYS does not.  See  the NYS DOH frequently asked questions page on the website.  Which means, you may charge for administrative time so long as you are not subject to a contractual or other limitation prohibiting from you from charging.  For instance, if you are a participating provider you are contractually agreeing to accept a set, designated reimbursement (hopefully negotiated) for certain services to patients, for which such negotiated fee is contractually required to represent certain administrative work associated with such are - i.e., prescriptions.  Where a patient has paid a visit to your practice and you have been reimbursed for their visit your in-network rate, and you have prescribed related to that visit, the prescription may be deemed a part of the service you have been reimbursed for and any additional charge may be seen as a contractual violation.

Here, the paperwork specified is a disability form which in most instances calls for the patients treating provider to complete information related to the disability, which may be unrelated to insurance reimbursement or provider payment, however, NYS as you have specified provides reimbursement.  You may run the risk of a potential patient complaint, since patients never want to pay for anything, let alone where the practice may already be receiving reimbursement and "double dipping". I am also generally concerned that charging for certain forms, specifically for disability, and not other forms, may result in potential liability, inclusive of potential claim of discrimination if you regularly perform certain administrative duties for other patients who are not claiming disability - which is a protected class under federal and state statutes.  Of course there is a difference between complying with administrative duties for patients versus devoting hours of your time towards completing absurd forms.  While you may not wish to adopt a strict charging policy, you may also settle on defining a fine line of efforts expended complying with burdensome administrative requests.

Admin you absolutely can charge for - services not covered by any insurance or reimbursed by any third party - which is why colleagues of yours may successfully be charging for certain "concierge" services, including "exclusive" access, after hours care, email capability, etc.   

If you aren't sure whether the forms are "charge available", run it by us. 

 
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