Little added fees = pissed off patients.
If you're adding small fees to your service to cover your costs, you're pissing off your patients. If you didn't guess, pissed patients don't speak kindly of you. Actually, I'm a proponent of the flat fee. I hate the little charges.
From Ronda Abrams
When I went into business, I sat down with a lawyer to review my legal and tax responsibilities. When we finished, he gave me some wise advice.
"Rhonda," he said, "don't nickel-and-dime your clients. Clients willingly pay thousands of dollars in hourly fees without complaint, but if I bill them $2 in long-distance calls, they'll get upset. It's small items that alienate clients."
We all react negatively to what we see as petty little fees that should be part of what we've paid for. A patient might be willing to spend $3000 for liposuction but she doesn't want to be charged for the laundry service or the support hose. The tiny fees at the end mark you as a cheapskate. It's better to charge an extra $100 for the service and give the hose away for free.
Make the most of the fact that you're not charging for these extra services. After all, you're a physician angel and friend to all your patients, right? Have your front desk go through the bill detailing the little suff as "Complimentary" or "Fee Waived." That lets the patient know you could charge them but haven't, increasing customer loyalty. Make the last interaction the most pleasant; go ahead and give the wheelchair ride for free.