Read the official blog post about Developing a Rock Solid and Compliant Discounting Policy.

It is important for practices to establish policies to distinguish who is able to pay for healthcare services. As charitable as you may want to be, the law does not allow routine discounts of more than 15% (per the O.I.G) from your actual fees, write-offs of co-pays and deductibles without risk to the doctor for violating payer contracts or federal and state laws. If patients have insurance, the practice must document that financial hardship actually exists and should record any fees that are waived. Also, hardship should be assessed regularly, as a patient’s financial condition may change.

Most Hardship Policies are based upon state or federal poverty guidelines. 

If you do not create your own hardship agreement, we recommend contacting KMCuniversity.com, as they sell an out of the box hardship agreement that's based on the federal poverty guidelines. Be sure to mention "Cash Practice" when you order.

Hardships can also be established by other groups of people as well.  For example, you could create a hardship agreement for Students, Single Parents, etc.

No more than 5% of your patient base population should be on hardship.

The key thing to remember though is a hardship is NOT based on how you get reimbursed.  In other words, just because someone is "cash", does not make them qualify for a hardship.  

Also, if someone does qualify for hardship discounts, those discounts still apply - even if they are on a P.I. case.  Again, the qualification is NOT based on how their care is being paid for.