As health care costs rise, more patients are switching to high-deductible insurance plans.

When that deductible hasn’t been met, doctors are becoming more aggressive in asking for their payment up front.

This move entirely makes sense, since like other businesses, physician practices are also wading through the difficult economic times.

According to the LA Times, 13 percent of a practice’s revenue comes from patients, and by becoming more proactive at collections, it “may be the only way they can stay open and continue to see patients.”

So, the next time you visit your doctor, and have a high-deductible insurance plan, bringing $10 or $15 for a co-pay may not be enough.