Traverse City Record-Eagle

March 26, 2013

Some balk at Munson's request to pre-pay deductibles, co-pays

By Anne Stanton
Traverse City Record-Eagle

---- — TRAVERSE CITY — Stay-at-home dad Caleb Smith received a jolt when Munson Medical Center called to schedule a prescribed ultrasound and then asked for a credit card payment to cover his $330 deductible and co-pay.

He declined because he didn’t want to give his credit card number over the phone. He was then told he “had the ability to pay” when he arrived for the ultrasound, he said.

“They were holding my health hostage. ‘Pay now, pay in three days or forego a doctor-recommended procedure,’” Smith said. “In this situation, they held all the cards.”

Karen Popa of Munson Medical Center regrets that Smith had a bad experience. He should have been informed of his third option: paying the bill when he received it. The hospital’s patient access service representative made a mistake, she said.

Munson began asking patients to pay deductibles and co-pays in advance of scheduled in-patient stays and procedures last fall. In the past, patients were routinely billed only after the procedure or hospital stay.

Popa said health care reform is changing how hospitals and insurers operate. Both are examining how they operate in order to “stay financially strong in the community,” she said.

“So informing patients beforehand is one of those changes,” Popa said. “We don’t like patients being surprised by their bills.”

That element of surprise is occurring more often as more people shift to insurance plans with higher deductibles. They may not understand their new policies, and end up with a bill much higher than expected, she said.

“As a patient, if I were in that situation, I would want to know ahead of time,” Popa said.

The real goal is for patients to understand their insurance coverage before the procedure. If the patient can’t pay, Munson can talk to them about other options, she said.

Munson’s financial counselors can work with patients to establish payment plans or financial assistance before and after health care is delivered. Counselors can help patients apply for Medicaid or find other sources of funding, including Munson’s own financial assistance program, she said.

Smith likes the idea of knowing the balance due ahead of time, but added the optional prepayment policy benefits Munson and not the patient. Being asked for a credit card payment added an element of anxiety to his already worrisome situation, he said.

“Munson knew that I was in a vulnerable situation, as any patient is,” he said. “What was I supposed to do? It’s not like any other situation. It’s not as if I could ‘shop around’ for a better deal.”

He wonders how many patients — too embarrassed on the phone to acknowledge their financial troubles —might just cancel a life-saving procedure.

“I can’t express how wrong that it is,” he said.

He had the money, but Smith called Munson to cancel the ultrasound on his throat. At that point, he was told that he could pay the bill after the procedure. He canceled anyway. His doctor had prescribed the procedure to determine if hypothyroidism was the source of his neck pain. Smith decided to wait and see if there might be another cause mentioned by his doctor.

“The choice was a very stressful one,” he said.