These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.

Wednesday, January 18, 2012

Giving doctors your credit card before an appointment

Giving doctors your credit card before an appointment

Many physicians’ offices have started a new practice – asking for a credit card deposit before scheduling an appointment.  This is much more common for new appointments, but you may also see this with repeat appointments.  Some just ask for the number, some actually charge a deposit.  Why? 

There are several reasons.  This is an incentive for patients to actually keep their visits.  We have a remarkable number of “no shows”.  In some offices, for new patients, this can be as much as 75%.  This time is reserved for the particular patient, and we can’t fill it with someone else.  We still have to pay our staff and overhead.  So we lose money if you don’t show up.

It’s interesting that we don’t even blink when we are asked to give that same credit card for a car reservation, a hotel room, or even a table at a restaurant.  But putting a deposit down at a doctor’s office?  It’s like we actually have to pay for health care!

That’s the issue.  We have become so disconnected from paying for our medical care.  “Bill my insurance” is commonly heard in every front office.  Patients have no idea about deductibles and co-pays.  They also have no idea what it costs to wait for their insurance to pay and bill for the difference whenever we finally hear from the insurance.  Often patients don’t pay at that point. 

New fees

It’s a good idea to ask about cancellation policies when making your appointment.   Insurance companies don’t pay those fees.  Every office has different policies.  Some practices waive a fee if illness keeps you from turning up.  Some offices will give you written policies.

Some medical practices have introduced other fees in the past few years for things that were previously free or for which a patient might not expect to pay.  A physician’s office in New Mexico charges a $10 fee to rewrite prescriptions for controlled substances, which expire seven days after first issued.  A family practice physician charges his patients a per-visit malpractice insurance surcharge.  Other surcharges reported among family physicians include a charge for referring patients to specialists and for a prescription or refill not attached to an office visit.  You will also start to see fees for paperwork like FMLA, physical forms, pre-authorizations, insurance issues, etc. 

You may try reading your doctor’s Web site carefully to see if things that were once free now come with a price.  You can also ask when you schedule your appointment or when you come in for your visit.  Doctors are charging for more of these types of things because they are becoming much more time consuming without payment.  Insurance companies and patients are also paying less and less for each visit.  We have to spend our time or our staff’s time (or both) doing so many of these things. 

See future post: Example of “Just a Medication Refill”

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