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”

She Wants What?

Princess reported the following phone conversation:

Mrs. Wantsitall:  I need to cancel the appointment for my daughter this afternoon.

(This is less than 24 hours notice – we charge for this)

Princess:  Why would that be?

Mrs. Wantsitall:  The kids were approved for insurance you don’t take last week, so she is going someplace else.

Princess:  OK.  Are you keeping your appointment?

Mrs. Wantsitall:  Yes, but I don’t want my Pap smear today because I’m feeling sort of crampy.

Mrs. Wantsitall:  By the way, can the doctor write a letter for Teenage Wantsitall for school to break the rules because she wants to, and have it done by 1:00 PM today when I come in for my appointment?

Princess said she would check. 

Note that she has been getting samples of her birth control pills from us when she doesn’t have the insurance we don’t take because we understand about Mom’s financial issues. 

This is what we as doctors have to deal with on a daily basis.  :-(

Medical Office Quandaries - 4

Missed Appointments

I’m sitting here staring at the walls at the moment because a patient didn’t bother to show up for her visit that was booked for an hour.  Ms Noshow also didn’t bother to cancel.  Princess called her twice yesterday and again this morning to remind her that she had an appointment.  The current phone number went to voice mail. 

She has been a patient for a little over a year.  I have at least 5 different phone numbers in her chart.  There are multiple notes in this patient’s chart about leaving messages, phone not being turned on, and her phone not being in service.  It helps to write this down, so Ms Noshow can’t say we didn’t try.

PEOPLE!  What happened to common courtesy?  It doesn’t matter whether it’s a 5 minute visit or a 2 hour visit – that time was reserved for you.  If you’re not coming, you should call.  It has gotten to be so common for people to forget that most offices call one or two days in advance to remind people. 

Several years ago, I finally instituted a charge for this.  Princess and I agree that wasting our time needs to be paid for.  Some people don’t pay the charge.  We don’t see them ever again.  Sigh.

If you PROVOKE PRINCESS 2

If you PROVOKE PRINCESS

Here’s your POTENTIAL PENALTY *

What we want to charge patients for:

Inquiring about your appointment time after the first $5.00

Please keep those little appointment cards we give you.  Or write the appointment down somewhere. 

*I’d like to make this a recurring feature. Princess and I get certain patterns of phone calls that we find annoying. We would like to present them to you, with what we would like to charge for them. Unfortunately, we can’t. Charge that is. The phone calls will remain annoying. Princess says she could get rich if she could charge for all this stuff.

Another Office Conundrum

Princess calls all our patients the day before their appointments to remind them about their appointment.  It is very common for doctor’s offices to do this.  Why, you ask?  Because people forget that they made the appointment.  They don’t come to the office.  We sit around looking at each other.  Other patients who could have come in for appointments can’t come in.  Besides, it costs us money every time someone doesn’t come in.  That raises the price for everyone else. 

What happens when Princess calls? 

Her favorite thing is to talk to the person who made the appointment.  They confirm it.  Everyone is happy.  This is a rarity.  Her next favorite is to get the machine and leave a message.  This is more common.

I hear a lot of grumbling about numbers that are “not in service”.  Another complaint Princess makes often is that mailboxes are full.  We have people that won’t answer their phones at all.  We have people that answer the phone and say they have no idea who that person is. (????)

My personal favorite is when Princess calls someone and they deny ever having made the appointment.  Princess is the only one that makes appointments.  So she KNOWS that the person made it.  She won’t let anyone but the patient make an appointment.  She knows it wasn’t the mom or the husband.  I don’t treat Alzheimer’s patients. 

Several years ago I instituted a “missed appointment fee”.  If you don’t show up, there’s a charge.  This covers part of the time we waste when you aren’t here.  It’s also a stimulus to keep your visit.  I think that’s why people say they have no idea what Princess is talking about.  

Yeah, right! 

You can’t be seen until you pay that fee.  Most patients have no intention of ever paying it.  I’m so sorry.  That’s how I get rid of patients who are unreliable.  My cardiologist told me I need less stress.  This helps me, but I’m a little worried about Princess’s blood pressure.