Equally distributed to the insurance company and the patient. If you give a dollar amount of $100 them $50 is applied to the patients account and $50 is knocked off what the insurance pays you as the provider. Insurance is the devil. If they audit books which they are entitled to do as a per the contract, and they see a sufficient amount of discounts only going to the patient side of the ledger then they can demand restitution of those funds. Typically they will withhold future payments by them in order to recuperate those funds. So as per the contract it is technically breaking the agreement.

I don’t use insurance with immediate family members, for extended family members I sometimes give equal discounts for ins and patient or I just tell extended family members due to insurance contract we don’t give discounts anymore. My fees are ‘discounted’ to begin with lol