Q: how can you reduce a patientžs fee without having an insurance company charging you with a duel fee system A: Thanks for your e-mail. Do you know of just one case where insurance companies have "charged" anyone with charging a dual fee. What do you think the managed care companies do .. they have multiple fee schedules within the same company. Cash discounts are very common and within reason will be perfectly legit. As I mentioned in the e-mail newsletter .. rather than lower the fee just place the patient on an extended payment plan and keep the fees the same. If possible always get their credit card number on account so you donžt have to hunt them down all the time for payment. If you are overly concerned about the dual fee problem .. call 1-800-239-3552 and join PCD (Preferred Chiropractic Doctor) .. this is a legitimate company that allows you to lower your fee when the patient spends $35 to join their group .. there is no expense for you. I am not sure where you practice but PCD is involved in a number of states.