INOVA Fairfax Hospital - Forced to Prepay

[Anonymous]

My Inova doctor wanted me to get some scans recently and referred me to Inova's radiology and diagnostic imaging center. Upon arrival, there were signs directing me to check-in electronically at the kiosk. The kiosk told me that Inova had estimated my out-of-pocket cost for the scans at $XXX, and forced me to prepay this amount (with a credit card) in order to complete the check-in for my procedure.

I am just dumbfounded by this -- never had it happen before. And can't say I like it. The normal SOP has always been for Inova to bill my insurance, see the reconciliation on the EOB statement, and then pay the remaining patient amount out-of-pocket. Inova is essentially circumventing the insurance benefits process to get their money 30 to 60 days earlier and make money on that money. It forces the patient to add an extra reconciliation step and takes the money out of the patient's bank account.

I called Inova's financial department afterwards to ask to opt out of this policy. They would only refer to me to the estimating department to gain my confidence that their estimates are correct (which presupposes that I wish to continue relying on their estimates), or referred me to the office manager at the radiology and diagnostic imaging center. Apparently they said it was the decision of that department to do this, and claimed it was not a policy that Inova had across its enterprise, so needed to be handled at a unit by unit level by the patient.

This has really shaken my trust with Inova. The whole practice is borderline predatory and should be illegal. Anyone have any experience with it? I saw an older post on DCUM from 2011 about someone havind to do this with Inova before having a baby, but nothing since.

[Anonymous]

Sounds like they've gotten stiffed too many times. There are other options for radiology, if you choose to go that route. Hospitals typically have good machines and good radiologists, though, if that's important to you.

[Anonymous]

While they've undoubtedly been stiffed a few times, this sounds like a profit-driven policy.

If the OP was forced to pre-pay $1,000 for a procedure, let's assume Inova gets that cash 60 days earlier than billing the OP's insurer and letting the EOB process play out.

If Inova puts that money into a simple high-yield (5%) savings account, that $1,000 with compounded interest becomes $1,102.50 after 60 days. Inova makes another $102.50 in profit off of just one patient.

Now multiply that by the thousands of patients they're forcing this on, and you're talking about a new revenue stream worth millions.

It's completely shady and a sign of all of the things that are wrong with for-profit health care.

[Anonymous]

This is fairly standard in my experience. Part of the reason is that the No Surprises Act requires health care providers to make these estimates and provide it to you upon demand.

You can complain to Inova, but they are going to give you the same wishy-washy answer. You should complain to your insurer and ask if Inova can do this per the terms of Inova's contract with the insurer. When you ask that question you will find a lot of things providers can't do but will still try anyway.

[Anonymous]

Anonymous wrote:While they've undoubtedly been stiffed a few times, this sounds like a profit-driven policy.

If the OP was forced to pre-pay $1,000 for a procedure, let's assume Inova gets that cash 60 days earlier than billing the OP's insurer and letting the EOB process play out.

If Inova puts that money into a simple high-yield (5%) savings account, that $1,000 with compounded interest becomes $1,102.50 after 60 days. Inova makes another $102.50 in profit off of just one patient.

Now multiply that by the thousands of patients they're forcing this on, and you're talking about a new revenue stream worth millions.

It's completely shady and a sign of all of the things that are wrong with for-profit health care.

Inova is a nonprofit hospital.

[Anonymous]

We had to do it in 2022 for a ped GI procedure.

[Anonymous]

Truly don’t understand how requesting payment at the time services are rendered is predatory.

[Anonymous]

Anonymous wrote:Truly don’t understand how requesting payment at the time services are rendered is predatory.

NP. To me it depends on how good the estimate it. I've been requested to pay way, way above what I'd ultimately owe, with no flexibility of the provide to look at my insurance benefits because some other insurers don't cover XYZ. Plus they were basing the estimate list price and not my insurer's allowable charges. This wasn't at Inova, though, so I don't know how accurate their estimates are.

[Anonymous]

Of course they did.

Most places do this.

I was just at Washington Radiology they did this.

Same with my mammogram at another facility.

And DD extrays for broken elbow.

[Anonymous]

Anonymous wrote:While they've undoubtedly been stiffed a few times, this sounds like a profit-driven policy.

If the OP was forced to pre-pay $1,000 for a procedure, let's assume Inova gets that cash 60 days earlier than billing the OP's insurer and letting the EOB process play out.

If Inova puts that money into a simple high-yield (5%) savings account, that $1,000 with compounded interest becomes $1,102.50 after 60 days. Inova makes another $102.50 in profit off of just one patient.

Now multiply that by the thousands of patients they're forcing this on, and you're talking about a new revenue stream worth millions.

It's completely shady and a sign of all of the things that are wrong with for-profit health care.

Your math is wrong. 5% interest on $1000 for 60 days is more like $8.

[Anonymous]

OP back... just spoke with my insurer who said this practice is allowed and there's nothing that can be done about it. They acknowledged that errors can be made, and recommended reconciling prepayment amounts with the EOBs when they arrive. They said they have no visibility into what Inova collects pre-paid from the patient, and there is no initiative underway to challenge this practice contractually. The insurer said this is becoming more and more common.

I guess there's not much that can be done. The principle of it just bothers me -- circumventing the established process to prepay for a procedure for which the outcome is unclear. Guess it's time to shift the ole' paradigm.

[Anonymous]

Anonymous wrote:

Anonymous wrote:While they've undoubtedly been stiffed a few times, this sounds like a profit-driven policy.

If the OP was forced to pre-pay $1,000 for a procedure, let's assume Inova gets that cash 60 days earlier than billing the OP's insurer and letting the EOB process play out.

If Inova puts that money into a simple high-yield (5%) savings account, that $1,000 with compounded interest becomes $1,102.50 after 60 days. Inova makes another $102.50 in profit off of just one patient.

Now multiply that by the thousands of patients they're forcing this on, and you're talking about a new revenue stream worth millions.

It's completely shady and a sign of all of the things that are wrong with for-profit health care.

Your math is wrong. 5% interest on $1000 for 60 days is more like $8.

This. Take your outrage and bad math elsewhere. You want a procedure you need to pay for it. End of story.

[Anonymous]

Medstar required this for a surgery I had in November 2022. And then again for an MRI I had last fall.

[Anonymous]

I wouldnt use them honestly. Quest does this and every time they give me some bogus amount due and I tell them that its incorrect because I know my benefits and labs and imaging are covered at 100%. I decline to pay ahead of time.

Now if you have coinsurance or copay thats a different thing unfortunately because its a known. This is why I wont choose insurance with a coinsurance because its usually x% of allowable amount and the allowable amount is contracted which means you may over or under pay and getting your money back from every healthcare facility you use is a pain in the arse.

This is the system you get when insurance is too complicated.

[Anonymous]

I don’t blame them. If you ran a business would you want to wait 60 days to get paid? The payment is your responsibility; sort it out with YOUR insurer.

But yeah I’d be mad too