Can physicians charge whatever they want to Insurance Payers?

CodeCast | Medical Billing and Coding Insights

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4M ago 14:22

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A question I’m often asked is, “Why do physicians charge so much?” There’s no easy answer, as there isn’t a fixed price list for medical services. Due to the healthcare system’s complexity and the absence of set prices, providers are largely free to charge what the market will bear.

However, can there be consequences for over-pricing or egregiously overcharging payers? Yes. It’s crucial to pay close attention to this issue, as it could lead to trouble not only legally but also in terms of regulatory compliance.

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