The world of high-deductible insurance – where you may pay a higher rate than the uninsured:

Case in point: Lisa Stamm of Kendall, who had a simple earache and got slapped with a $375 bill for about 10 minutes with a nurse practitioner. If she had no insurance, she could have paid $125. If she had a no-deductible policy, her insurer might have paid about $140, and she would have paid nothing.

Expect this trend to continue. (via The Health Care Blog)

An upcoming problem for high-deductible insurances is that it will place the onus of collection on the physician. One way to combat this is to require all patients to give a credit card number:

So why not do what a growing number of businesses, including every hotel, motel, and country inn on the planet, already do: Ask each patient for a credit card, take an imprint, and bill balances to it as they accrue.

Geoff Anders, president of the Health Care Group Inc., suggested this in a talk that he gave at a recent meeting, and it hit me like the proverbial ““whack on the side of the head””: Why haven’t we all been doing this for years?

After all, patients think nothing of handing a credit card to a busboy in a restaurant, with little or no concern for what he might do with it in the kitchen. They blithely shoot credit card numbers into a black hole in the Internet. So why should they object to doing the same thing with their medical bills?

Beginning last January, every patient entering our office has been handed a letter at the check-in desk explaining our new policy of asking for a credit card number on which any outstanding balances will be billed. (See box below.) At the bottom of the letter is a brief consent for the patient to sign, and a place to write the credit card number and expiration date.

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