Oct 12, 2009 5:15 pm US/Pacific
Co-Pay? Not Some Doctors; They Want It All
Patients Stuck With New Trend, Timing Couldn't Be Worse
NEW YORK (CBS) ―
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Christopher Furlong/Getty Images
Insured patients typically expect to make a small co-payment when they see a doctor, and later get billed for anything else they owe.
But some physicians no longer want to wait for their money and are asking for full payment up front, reports CBS station WCBS-TV in New York City.
Pat Andre usually pays a co-pay of about $10 when she visits her doctor for regular osteoporosis exams. But recently the office told her to be prepared to pay the entire bill up front and in full.
"If you don't have the money, you don't get the care," Andre said.
It's a growing trend. Doctors and clinics are increasingly asking people to fork over their entire out-of-pocket charge at the time of their visit. That could include paying amounts a patient owes toward their health plan's deductible and a percentage of the cost of care under a co-insurance requirement. Critics say it couldn't happen at a worse time.
"It can be a serious issue for consumers who need to see the doctor," said Kathleen Stoll of Families USA.
But proponents say it's necessary because often when bills are sent to patients after treatment physicians typically recover only about half. Some doctors are taking it one step further by not dealing with insurance companies at all.
"The patient will get reimbursement by the insurance company for their visit at whatever contract amount has been negotiated with the insurance company," said Dolores Kent, MD, FACS.
But justifying the practice by saying it will get patients better care.
"Here I get a chance to listen to my patients, and talk to my patients and that has a huge effect not only on my patient relationship, but also on my ability to treat the patient, diagnose them," Kent said.
Still patient advocates say just like any other bill, know what you're paying for.
"You have the right to negotiate with your doctor to see what terms he might be willing to offer you. I encourage patients to do that," Stoll said.
Even if you pay whatever the doctor's office requests before you walk out the door, you should carefully watch for the final explanation of benefits from your insurer. If it says you owe a different amount than the doctors office collected, call and request a refund.
You can also ask your insurer about its rules. Some don't allow health care providers in their networks to demand upfront payments beyond basic co-pays.
(© MMX, CBS Broadcasting Inc. All Rights Reserved.)
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