Thomas Zordani flew from his home in Denver to Phoenix for a consultation with a Mayo Clinic neurosurgeon, hoping to find out what could be done to treat his debilitating headaches after worrisome brain scan findings.<\/p>\n
When making the appointment, Zordani said, he\u2019d been told the clinic was in his insurer\u2019s network. Upon arrival, Zordani was summoned to the clinic\u2019s financial office and told he had to make a $5,000 preservice deposit, because Mayo had since determined it did not accept his insurance. He was automatically designated \u201cself-pay,\u201d even though his plan had out-of-network benefits.<\/p>\n
Not having that kind of cash on hand \u2014 and angry on principle \u2014 he refused. His appointment was canceled.<\/p>\n
\u201cI was so livid,\u201d Zordani said, recalling that day in early April 2024. He later learned that Mayo had sent a message to him in his insurance carrier\u2019s patient portal shortly before his visit with an estimate of the cost: $565, not the larger amount it later demanded.<\/p>\n
Traditionally, patients usually receive bills for their share only after getting treatment. But what Zordani faced is becoming increasingly common \u2014 hospitals or other medical providers seeking prepayments.<\/p>\n
\u201cWe regret that this individual\u2019s experience did not meet the high standard of communication we strive to provide when helping our patients understand their insurance coverage and financial responsibility,\u201d Andrea Kalmanovitz, Mayo\u2019s communications director, said in an emailed statement. \u201cWhen prospective patients don\u2019t have clarity that Mayo Clinic is not in-network with their health plan, unexpected pre-service deposit requests may result.\u201d<\/p>\n
Mayo\u2019s website<\/a> says it requires prepayments in a variety of cases, including for \u201cnoncontracted\u201d \u2014 also known as out-of-network \u2014 insurance plans.<\/p>\n The trend of hospitals asking for money up front represents a double whammy for patients.<\/p>\n Medical providers are collecting larger shares of what patients might owe at a time when rising deductibles mean patients are owing more for care. The preservice charge could be all or part of a remaining deductible, for example, or a sizable percentage of what the visit or treatment might cost. Those deductibles go up when hospital prices, drug costs, and labor expenses increase, as insurers try to slow premium growth by shifting more costs to patients.<\/p>\n People are \u201cbasically being asked to self-insure,\u201d said Richard Gundling, a senior vice president at the Healthcare Financial Management Association, an organization for finance professionals.<\/p>\n As that happens, hospitals figure more patients will have trouble meeting those deductibles, so they want to get as much up front as possible.<\/p>\n \u201cThings like preservice deposits and those kinds of moves are probably going to become more and more likely,\u201d said Chip Kahn, a visiting senior fellow at KFF and the American Enterprise Institute and former president and CEO of the Federation of American Hospitals. \u201cThat will make it harder on the provider, the clinician, and harder on the patients.\u201d<\/p>\n The deposits can\u2019t be viewed in isolation, Gundling said: It\u2019s a bigger issue than just hospitals asking for money up front. The challenge, he said, is: \u201cHow do we maintain access to care when more patients can\u2019t absorb the level of out-of-pocket costs?\u201d<\/p>\n Already, consumers are increasingly worried about paying for healthcare. A recent KFF health tracking poll<\/a> found that lower out-of-pocket costs ranked as the top change insured adults would like to see from their coverage plans. KFF is a health information nonprofit that includes KFF Health News.<\/p>\n The average deductible in family coverage offered by employers is $3,762 per person, according to KFF<\/a>, while the average deductible in Affordable Care Act plans jumped 37% this year<\/a> to a similar amount, $3,786.<\/p>\n![\"Newsletter](\"https:\/\/kffhealthnews.org\/wp-content\/plugins\/kff-shared\/dist\/\/images\/newsletter-icon.png\"){kind=icon}
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