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PA hospital requests payment for patient care, up front

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upfront payment
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Michael Walsh
Hospital Billing
deductibles
co-pays
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Abington Memorial Hospital

Pennsylvania-based Abington Memorial Hospital has adopted a more proactive and aggressive patient billing policy, requesting payment upfront. However, the policy adopted by several departments, including outpatient registration, radiology and emergency, is voluntary. But the hospital strongly encourages it, and even inpatients are asked to pay their deductibles and co-pays that can hit $1,200 before they check out.

As out-of-pocket medical costs rise, patients are still dodging or delaying co-pays and deductibles. The hospital acknowledges that some of its staff are uncomfortable tapping patients for money. Management urges billing and administrative staff to try to soften the pitch by saying it's a chance to explain insurance benefits, and to help patients pay conveniently.

Like many other hospital executives across the country, Michael Walsh, Abington's CFO, says he needed to do something to attack the bad debt that had racked up from uncompensated care.

"People are always less likely to pay after the fact," Walsh said. The new strategy has "had a positive impact on our bottom line." From last July through this past February, upfront fees paid to Abington were up from $303,518 for the same period in fiscal 2008.

The upfront billing strategy adopted by Abington is part of a national trend according to Alan Zuckerman, president of Health Strategies & Solutions. Zuckerman says that hospitals have been increasing up-front collections for the last two or three years, with "more acceleration in the last six months."

To learn more:
- see this Philadelphia Inquirer story

Related Articles:
Number of hospitals requesting up-front payments continues to expand
Trend: Hospitals requiring up-front cash payments before treatment
HMA adopts tougher collections strategy

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I am not sure why this is considered very radical. As far back as the mid-70s, hospitals were routinely collecting deductibles and co-pays from patients. The very first time I was ever an inpatient, I was requested to pay up-front. It seems no different that a hotel asking for a credit card to guarantee payment.

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