By Rod Moser, PA, PhD
It may be happening to you or your family at a medical visit without anyone ever disclosing it. Many clinicians will “down-code” a visit to a less-expensive charge if they know that the patient or family is having financial difficulties. You may go to the front desk and pay, only to be puzzled when the charges were less than you expected, or you may expect a bill to come in the mail but it never does. Without any fanfare, your doctor may be secretly helping you.
Some medical providers will nonchalantly inform you that they have adjusted your bill. They may tell you why or not. If a patient was forgotten in the waiting room because a staff person failed to put their chart in the “to be seen” file, then they deserve a free visit in my opinion. If the charges for an individual service or procedure are so outlandish that the medical provider is embarrassed to bill it, then the charge may mysteriously disappear. I have heard stories of medical offices overcharging patients for services they did not receive, but in my opinion, it is more common for patients to be cut a financial break.
More and more medical providers work on salary. They do not personally see any of those charges that go directly to your insurance company or wallet. Medical groups will track their productivity, but if an occasional “no charge” visit comes across the bean-counter’s desk, or an obviously down-coded charge, it may not get noticed.
I love giving stuff away, and that includes no-charging a few patients who cannot afford medical care. When it comes to cash-paying, out-of-work families trying to make ends meet, I have a hard time not helping, especially this time a year. If I was in private practice, I would probably go bankrupt. It is a really nice holiday gift to treat a few people for free. It doesn’t hurt at all and I think every medical provider should be doing it. I see a lot of Medicaid patients in my practice and state reimbursement rate is so low that it is often more cost-effective to treat them for free.
I get really defensive when I hear people complaining about money-grubbing, over-charging doctors. The ones that I know are not like that. They all have big, caring hearts.
When I found a little boy in Jamaica that needed a life-saving surgery, I made the calls. The first surgeon that I called said, “Sure, if you can get him to the States, I will do the surgery for free.” He didn’t even hesitate. He put me in touch with the hospital he uses, and I spoke to the hospital administrator. Again, he said the hospital would provide the OR and all his care for free. The hospital put me in touch with the local travel agency that they use, and guess what? They flew the little boy with his mother to the United States for free. The family stayed with us for a week or so until he could return to Jamaica, and my PA students took up a collection to buy them both some appropriate winter clothes! I am often amazed at the generosity of strangers.
So, I am challenging any medical provider who may be reading my blog to give away a few free visits. It won’t hurt your bottom line a bit, and it will make you feel better. The medical profession has become so profit-oriented that we often forget why we do what we do.
We are in medicine to help people, and what better way to help someone than to provide some free care once in a while?