Hospitals are now requiring patients to pay upfront before receiving care, a trend that is becoming more common. This shift is partly due to rising deductibles, which mean patients owe more for their care. Thomas Zordani, a patient from Denver, experienced this firsthand when he was asked to make a $5,000 preservice deposit at the Mayo Clinic in Phoenix.

Rising Deductibles and Upfront Payments

Zordani had been told that the clinic was in his insurer’s network, but upon arrival, he was informed that Mayo did not accept his insurance. He was automatically designated as a self-pay patient, despite having out-of-network benefits. The clinic’s financial office demanded the $5,000 deposit, which Zordani refused to pay, resulting in the cancellation of his appointment.

Experts say that hospitals are collecting larger shares of what patients might owe, and this trend is likely to continue. Richard Gundling, a senior vice president at the Healthcare Financial Management Association, notes that patients are being asked to essentially self-insure. Hospitals are seeking to get as much money upfront as possible, especially since many patients struggle to meet their deductibles.

The average deductible in family coverage offered by employers is $3,762 per person, according to the Kaiser Family Foundation (KFF). The average deductible in Affordable Care Act plans has jumped 37% this year to $3,786. As a result, hospitals are becoming more aggressive in their pursuit of upfront payments.

Consumer Protections and Hospital Policies

While some hospitals, like Mayo and Johns Hopkins Medicine, have clear policies on prepayments, others do not. Patients who receive in-network care may have some recourse in their contracts with their insurers, but those who seek out-of-network care may not have the same protections. Experts advise patients to check their insurance contracts and hospital policies before seeking care.

In emergency situations, hospitals that accept federal Medicare financing cannot demand upfront payment before stabilizing a patient. However, other consumer protections are less clear, and patients may need to navigate complex hospital policies and insurance contracts to understand their financial obligations.

Original reporting: NBC10 Boston — read the source article.