CA doctors offices mandating payment upfront for services- is this legal? Why is this common practice? (Sacramento: house, deductible)

[Curmudgeon]

One of the few benefits of aging (along with retirement) is Medicare, especially if you have a top-of-the-line supplement policy. I've been on Medicare for four years (I'm 69) and have never had a copay even when I had $170,000 worth of neurosurgery. Thankfully my wife is on Medicare as well. It really is something to celebrate when you reach age 65.

[sunshinelove0000]

Perhaps I should clarify. I have no issues paying my copay. Even back home I paid my copay 99% of the time, however it was never an issue if I forgot my wallet or didn't have the funds to simply say "please bill me".... Also, one thing I am shocked at since moving here is the incompetence of front desk's ability to understand insurance. Like I said I have seen probably upwards of 10 docs since moving to CA and the front desk staff at all of the various docs have been completely clueless. I'm not used to that. Back home the people working the front desk understood what I meant when I said "Actually my copay is higher than the $20 listed on my ID card because I haven't met my deductible. I will need to pay the full amount of the contracted rate today because my deductible has no been met." In all honesty I would've been better off talking to a wall when explaining this to the staff I've spoken to since moving here. It's very frustrating because the people telling me how much I have to pay don't understand basic insurance terminology.

Additionally, my plan specifies that coinsurance must be billed and the insurance company dictates the allowable amount before I am to pay my coinsurance. Yet I am consistently asked to pay my coinsurance upfront. For example, the first time this happened I had my $20 office copay plus I knew they'd be doing an echocardiogram. The girl at the front desk told me if I didn't pay my coinsurance for the echocardiogram then I wouldn't be able to be seen and would be charged a no-show/cancellation fee. I agree to just pay the damn coinsurance. However she wanted me to pay a ridiculous amount!!!! I told her I would only pay my portion of the allowable amount determined by my insurance. This is what caused a whole debacle between me and the front desk. Back home this never happened. Not once! They never demanded my coinsurance upfront, they would agree to bill me later

[MarciaMarshaMarcia]

Originally Posted by NoMoreSnowForMe

I've lived in CA, WA and TN, and I'm pushing 60 years old. I have always been asked to pay my co-pay when I checked in at a doctor's or dentist's office. I do recall having to wait while they contacted my insurance regarding my coverage and my co-pay. I've never been asked to pay some weird inflated estimate.

I had outpatient surgery in SoCal in '09 (before Obamacare) & had to pay my "estimated share of cost" plus copays BEFORE my surgery...my spouse saw someone being turned away the day of their surgery (right after I was taken back for my surgery) b/c they couldn't pay this...they did not bring their checkbook to surgery! However, I had the same thing happen to me just this past spring in the state where I now live...so I don't think it's a California thing or a Obamacare thing...it's a greed thing.

One thing that did happen in SoCal...my spouse's Dr. decided to become a "boutique" physician...there is another term for it, which escapes me...but essentially, he sent a letter to all his patients, stating that for the "privilege" of continuing to be under his care, all patients would be required to pay an annual cash fee, above & beyond any insurance copays...it was $1,000/patient, as I remember...oh, and a "discount" for couples/families!

*Praying I live until Medicare...*

[CA4Now]

Originally Posted by sunshinelove0000

Is this unique to CA? Is there a reason why CA doctors seem to have such strict policies when it comes to paying before you're seen?

I don't know of anyone who pays such enormous fees up front. It may be written into your policy, though. You may receive more informative answers if you ask to have this moved to the Health Insurance subforum.

[CA4Now]

Originally Posted by TurquoiseOne

my spouse's Dr. decided to become a "boutique" physician...there is another term for it, which escapes me...but essentially, he sent a letter to all his patients, stating that for the "privilege" of continuing to be...

It's concierge care, but that's not exclusive to CA.

*Praying I live until Medicare...*

I second that!

[payutenyodagimas]

yes its legal.. the only time you dont have to pay upfront is during emergency

[willow1990]

Originally Posted by Bulldogdad

Proliferation of high deductible plans, deadbeats that don't pay their bills and Obamacare. Welcome to the new normal.

Don't blame Obamacare. That's a Republican ploy. Don't you remember, Obama said that he created the plan based on good old Romney's health care plan. And by the way, if you don't have health care, who do you expect to pay the doctor bills.

[UserName14289]

Originally Posted by FireFly2

Physicians in my state always ask for my copay before I am seen. My dentist requires my copay before I leave. I've actually never heard of a physician not asking for the copay upfront. It's strange that it would be state dependent.

I walk out of my Maryland doctor's office without paying a dime. They know how to mail a bill to me, and I pay it. Maryland has some of the best healthcare not only in the country, but the world. California on the other hand, well, you know the saying... if you have nothing nice to say. My experiences with CA healthcare have all been atrocious, so horrible that I was strongly considering flying from CA to MD to deliver my baby. I made the foolish decision to deliver in CA and lived to regret that lapse in judgment as well.

[oldtrader]

What has happened and is being ignored, is that the doctors have to be paid, so they can pay their bills.

In many areas with high cost of living such as California, people are having a hard time paying their bills. They pay utilities, and such things as they don't want their electricity, etc., turned off. Doctor bills too often just get ignored and are not paid when billed. Enough people do this, and the doctors cannot pay their bills without taking out loans, or digging into savings.

Doctors as many other services, have changed to charge in advance, to keep their cash flow coming in and manageable.

If all people paid their Doctor's bills on time they would bill people. Due to too many people not paying their bills on time, and causing them cash flow problems, they now demand the money up front.

Don't blame the doctors for this change, blame the people that slow pay or do not pay their doctor bills. They are the ones that caused this change.

[Electrician4you]

Ive never had to pay anything more than my copay. That's it. I think you guys need to look at your policies and see what they cover.
If you have a 5-10-15% portion of your bill to cover I can see why medical care expects to pay your bill in full. When you call a plumber or pay for car repairs you pay in full don't you? You're basically going in for a service call. Why would you expect the doctor to take payments? There is no law stating he must bill in payments. You don't like his billing practices go to a doctor that takes payments