What are more healthcare facilities demanding payment up front

Citygirl

SF VIP
Location
Pa.
Deb: my eye Dr. always did want the copay up front but I have no copays for lab work. I'd like to know why you object to the before payment. It is going to be paid one way or the other before you exit that door anyway.
 

I have two insurance plans. It seems everything would be covered.
Not all drs' offices will bill your secondary insurance for you, so you might have to submit a claim and wait for reimbursement. Also, here, there are some drs who have quit accepting certain secondary insurances because of payment issues so it is up to the patient to make a claim and get reimbursed.
 

Oris Borloff

New Member
One thing you may not be considering is that medical services are a business. With all the covid protocols in place their customer pool is restricted, reducing the cash flow and overall revenue. There are fixed operating costs to keeping the doors open even if half the staff has been furloughed due to reduced work load.

It's not all covid either. Sometimes, as happened in my state, after the previous governor cut medicaid payments and eliminated other state subsidized medical facilities, the small town hospital where my doctor is had to start getting up front co pays.

Add insurers into the mix, that fight reimbursement, down right refuse reimbursement, government mandates, and don't forget many laws governing these things in states were actually authored by insurance companies.

It's not a simple answer.

The whole system in the US is basically a mess. It was nearly 40 years ago when I worked in a hospital and I'm afraid it hasn't gotten any better.
 

So we are still on my husband's benefits plan, not Medicare, but for us it's customary to pay the co-pay on the day of the appointment.

However, in-network providers often ask us to pay the rest of the bill up front and we always decline, because nine times out of ten once we get the insurance bill we see the provider has attempted to charge well above the contracted rate or even double bill. So we insist that we'll wait to get the invoice. That way the insurance company has had the chance to review it first and adjust fees to the correct amount.

If the provider is 100% out of network we often have to pay up front, though. That's why we try to stay in network as much as possible.
 

mathjak107

Senior Member
most doctors who want money up front because of deductibles are in breech of their insurance agreements .

i once had a doctor i went to for the first time demand i pay up front since my insurer would not disclose how much of a deductible i had left ...

the insurer told them they wont tell them since i could have a claim already in house that meets my deductible .

so they forced me to pay 240 bucks up front ...

when i called my insurer they said he could be dropped for doing that ...their agreement is the insureds are not to be charged against any deductible until after the claim is processed
 

Aunt Bea

SF VIP
Location
Near Mount Pilot
The oral surgeon that is doing my implant doesn't accept any insurance, not that it matters to me since I don't have DI, but he did ask for $4800 before he even started.
Deb,

I have to say that did amaze me when I saw your post about handing over almost five thousand dollars to a dentist that you've only met once.

I'm not sure I understand how you could do that when you are usually so careful about getting several estimates and opinions before starting various home repair projects.

Good luck with your new tooth!
 
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Don M.

Well-known Member
Location
central Missouri
The oral surgeon that is doing my implant doesn't accept any insurance, not that it matters to me since I don't have DI, but he did ask for $4800 before he even started.
If you decide to go with another implant, check out Aspen Dental before you spend $4800., Their prices are less than half that, and they probably have an office within reasonable distance of your place. One of my son-in-laws mother has had several in the past couple of years, and she is quite pleased with the results.
 
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