You are not pre-paying the whole amount without insurance -- you are only paying your estimated portion. Since they have relationships with the insurance companies, they have a good idea what your out of pocket amount will be. That is not predatory at all; they are only getting their fair share up front, and there is nothing wrong with that.

If I recall, it used to be that they can't compel you to pay a coinsurance at time of service. Now, in my outpatient office, they ask for 42.30$ (or whatever) towards your coinsurance, but I don't think patients are required to pay, though it may sound like it. I would refuse, personally.
But the 30$ copay can be required and services denied if they don't pay at time of service.
I don't complete the online check in at a derm bc when I see the PA I only get charged a 20$ copay and if I see the MD i get charged 50$--I know this makes no sense but this is what is happening. So I wait until I am at the office and say that I'm only paying 20.

This was definitely the policy as early as 2020.

My brother had a scheduled shoulder surgery and had to pre-pay for his scans, a portion of the surgery suite (INOVA Loudoun), and a portion of the surgeon's fee. This was not co-insurance or a copay that his insurance policy had for these procedures... but having to pre-pay IS essentially a copay. I think total, OOP, he had to pay $4k. How many people in our area cannot afford to pay that OOP? And he has very good insurance. He doesn't pay anything for two meds he takes, my SIL has her GLP-1 fully covered, and all the supplies and insulin their T1D son needs are fully covered. I wish my kid's T1D supplies were fully covered! What a luxury that would be.

Anyway, I had emergency surgery, also in 2020 at the same hospital (INOVA Loudoun), and while they did not charge my card, they did need to do a pre-auth (believe that's what it's called) on it to make sure I did have the ability to pay. I was on pain meds but my mom, who was with me at the time, confirmed that I signed paperwork where I acknowledged that the portion I could be responsible for was $6k and I could pay. Seems like that wouldn't stand up in court, honestly. In the end, the total bill for my surgery was $42k and my insurance covered all except for $2100. INOVA billing sent me an alert after my surgery that the card that was pre-authorized would be charged $2100 on X date. Call blah blah if I needed to switch cards or make other arrangements.

Anonymous wrote:why should providers get screwed if insurance denies? my wife had a mamogram, all the insurance rules were followed and they still denied the charge and the provider is forced to write it off. enough is enough. as a provider I can you that times are changing. insurance is the problem at the end of the day.

This all day. Insurance companies are the predators here.

I also said “no thanks” to prepay and they were fine with it. In the end, they would have had to refund me $1000k and I’m glad I didn’t do it.

I had a broken leg and needed an MRI 10 years ago. FFRC made me pay by credit card before the scan. They gave me a discount I think because I was self pay.