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By Paul Goldfinger, MD, Editor @Blogfinger

Do you find flaws that indicate a deterioration in some aspects of our healthcare system? We often do and yesterday we stumbled on another one.

We were at a local medical group for an office visit. When we went to the desk to schedule our next visit, the face behind the glass asked for our credit card information. She assured us that they would only use the card if we had an unpaid balance, for example if there was a copay or a balance after insurance paid.

When we refused the idea that we should give them open access to our checking account  (ie a blank check), she informed us that she could not schedule our next visit without that card. In other words, they were willing to lose two patients who had no history of payment issues over this “policy.”

We were handed a statement in writing which explained that the “insurance industry makes patients responsible for high deductibles, co-payments and non-covered services.” In other words, they didn’t trust their patients to take care of outstanding balances and they hate to wait.

The statement said that if an unpaid balance exists, they would send us an email statement, and if we did not pay within 5 days, they would charge our credit card.   They also worried that we might change our credit card, so they concluded by warning that “you may cancel your credit card, but we will be unable to continue your care without an active credit card on file.”

Although we have been happy with our medical care with this group, this policy, which was willing to let us  leave without a subsequent appointment, casts a dark cloud over that medical provider.  To be honest, we were furious.  They are entitled to establish rules for collections, but this policy has a tinge of abandonment and coercion, something which is unethical among physicians.

For one thing, the policy makes our credit card available to anyone in the office who is interested in getting a new TV, for example.  It also makes it much more difficult to negotiate or discuss a billing issue once they have snatched your cash from your account.  And you need the time to do that because sometimes medical bills contain errors or even fraudulent charges.

Is this legal?  Evidently it is.  (quote below is from Cleveland.com)

“An AMA spokesman said, ‘Employers are offering health plans that require their employees to shoulder a greater share of health care costs. Total cost-sharing for the average patient from deductibles, co-payments and coinsurance has increased from $422 to $747 between 2004 and 2014, according to the Kaiser Family Foundation.’

“He said the cost-sharing trend is accelerating because of the health insurance exchanges opening up. Those often come with high-deductible plan options that people choose to keep their premiums down.

“Meanwhile, overhead for doctors’ offices has soared, he said, in part because of time spent complying with government regulations and health insurer policies.

“To lower overhead costs,” Mills said, “medical practices are focusing more on streamlining patient payment collections. Some practices do take credit card numbers for this purpose.”

“He added that the AMA does not offer guidance to doctors’ offices on this issue, except to say that doctors who do it should get advice from an expert because of the security risk of keeping this type of information on file.

“So the bottom line: If a doctor’s office won’t treat you  because you won’t give the office a credit card number to keep on file, then I’d find a new doctor. Period.”

We are not yet sure what to do, but this feels like blackmail and definitely affects our doctor-patient relationship.  The policy shows disrespect for the group’s patients, and a basic tenet of physician values is to always put the best interest of the patient first.

 

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