Some hospitals push upfront payments before electives

Some hospitals and surgery centers are requesting patients pay in advance for nonemergency procedures and are rescheduling surgeries when payment is not received beforehand, The Wall Street Journal reported May 9.

Advance billing is becoming a more common practice among facilities because it avoids costly follow-ups, debt collections and lawsuits over unpaid funds. About 23% of what patients owe is collected by hospitals before treatment, an increase of 3% since 2022, according to an analysis of data from 1,850 hospitals by Kodiak Solutions, a healthcare consulting and software company. Among the procedures hospitals want upfront payment for are knee replacements, CT scans and births. 

Despite the benefits it poses to hospitals, the practice can place extra stress on patients who are already dealing with serious conditions. Some patients told the Journal that they've had to put off procedures, while others who paid upfront later discovered they were overcharged and had to fight for refunds.

Hospitals argue that for some patients, knowing the cost ahead of service gives them the chance to shop around and avoid large unexpected bills. However, about half of adults would be unable to pay an unexpected medical bill of $500 in full without going into debt, a KFF report found. So most must borrow the money. 

Roughly half of the debt hospitals wrote off last year was owed by patients with insurance, Kodiak found.

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