Provided by: Jennifer Kirschenbaum, Esq.
May 9, 2024
Question:
Hi Jennifer,
A friend recently received a letter from his internal medicine /rheumatologist demanding patients pay an administrative annual fee, which they specify is specifically not a concierge payment for services or access. The doctor is in network with most insurances and Medicare. Is this a legal way to thin out his busy practice, but maintain his income, or is charging an annual administrative fee against the rules of Medicare/ insurance?
Thank you,
Dr. John
Hi Jennifer,
A friend recently received a letter from his internal medicine /rheumatologist demanding patients pay an administrative annual fee, which they specify is specifically not a concierge payment for services or access. The doctor is in network with most insurances and Medicare. Is this a legal way to thin out his busy practice, but maintain his income, or is charging an annual administrative fee against the rules of Medicare/ insurance?
Thank you,
Dr. John
So, the fee would likely be a violation of this doctor’s insurance contracts if the fee is not for any discernible service or product outside of required and covered insurance services. You can charge an extra fee for non covered services or access, but not an extra fee that is for admin related to covered services...The same answer will apply for filling out forms - disability or otherwise. No additional bucket of reimbursement will exist.
