Managed Care Contract Negotiations
Mar 30

Transitional discounts for out-of-network patients

If you have recently terminated a contract with an insurance carrier and now have become an “out of network” provider, how best to deal with your affected patients? Of course you will need to notify them of your decision to do so but how do you structure an appropriate fee structure so that you minimize the potential loss of patients? 


Many practices in this situation have had success using the phrase “transitional discounts” when implementing a pricing structure for out-of-network patients. The concept helps keep the patients in the practice (i.e. they don’t bolt to an “in network” provider) but doesn’t permanently reduce fee schedules for out of network patients.  It will take a bit more management but financially this is a good idea in the longer run.  

About Reed Tinsley, CPA

As a top advisor to physicians, I help increase practice profits by delivering hands-on, expert medical accounting/tax support, practice counsel, and revenue-building strategies. Read more →