More hospitals seek upfront payments from patients

Even if patients have insurance, hospitals still want their money before or just after providing care.

More acute care facilities ask patients to prepay prior to undergoing medical procedures or before they're discharged, CNN Money reported. The change in tack is primarily because of cost-shifting. More patients bear larger shares of their medical bills. And the silver and bronze plans offered by the state health insurance exchanges have deductibles as high as $5,000.

"The bronze plans are scaring a lot of administrators because the patient liability is so large," Debra Lowe, administrative director of revenue cycle at Ohio State University's Wexner Medical Center, told CNN Money. "Patients are unaware they have this high deductible." The hospital began to request upfront patients in July and hopes to collect 75 percent of what is owed.

Even among those patients with employer-based coverage, 41 percent have deductibles of $1,000 or more, Bloomberg Businessweek reported.

If the patients can't settle the bill at the time of services, some hospitals may float financing. "We are trying to minimize the after-service bill shock and get them into financial assistance or some other program for more affordable care," said Andy Scianimanico, vice president for revenue cycle at Northwestern Memorial HealthCare in Chicago.

However, the cost burdens may scare some patients away from care. "Tell me what 28-year-old is going to be able to provide, especially in this economy, $6,000 of their own money?" Jan Grigsby, chief financial officer at Springhill Medical Center in Mobile, Alabama, told Bloomberg Businessweek.

Aware of the loaded nature of collecting money from patients, the Healthcare Financial Management Association released draft financial guidelines late last year for how to best handle such interactions.

Patients also still have the option of waiting until their insurance handles the claim.

To learn more:
- read the CNN Money article
- here's the Bloomberg Businessweek article