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Healthcare: Payment in Full Upfront

Editor’s note: Does any other business require payment in full before services are rendered?


Medical practices seek full patient payment upfront
More medical practices in the U.S. are asking insured patients to pay their entire out-of-pocket charges, including deductibles and the patient’s share of the cost of care, upfront to ensure they get full payment. Uninsured patients are being asked to pay upfront or to sign up for a payment plan. Some practices also project patient costs and ask for payments for outpatient or elective surgeries and diagnostic tests. The Wall Street Journal


August 5, 2009 - Posted by | Cost, healthcare |


  1. Airlines charge for tickets, receive full payment, before your flight. Payment before service is rendered.

    Many hotels and resorts receive payment in full prior to your arrival and use of their facilities, one example, Disney World Resorts.

    Lawyers usually receive a retainer in advance of services to cover expenses as incurred, billing regularly so no balance exceeds an acceptable level at any time.

    A physician office expecting payment at time of service is not unreasonable – maybe they ask before going back to the exam room, maybe after the exam….but why is that a problem? Don’t doctors deserve to be paid for their service and care?

    Comment by Missy | August 6, 2009 | Reply

    • I think you’ve missed the point of the article. Of course doctors deserve to be paid for their service and and care. The point of the article is about getting paid in full before services. The other issues both parties suffer from is the patient knowing, like auto repair, an estimate of costs before services. The physician for their part is not sure what the patient portion of the cost will be even when services are rendered. We have been pushing for insurance companies to provide more price transparency and auto adjudication (like retail drug purchases).

      Comment by Health care -- how do we move forward | August 6, 2009 | Reply

  2. Given the difficult doctors, hospitals and other medical providers have collecting from patients after service, it seems reasonable in certain circumstances to request payment upfront. However, the more complex the procedure, the less likely it is that the estimated bill will be accurate, so it is probably good practice for the patient to negotiate an underpayment in these cases with full payment coming after the procedure. And yes, always make sure to carefully review the Explanation of Benefits after service.

    Comment by Joe | August 27, 2009 | Reply

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