Differences between third-party-reimbursement and payment-for-service By Dr. Sutton Graham on August 06, 2009

A recent article said patients were surprised to be asked to pay more than an insurance co-pay when visiting their doctor for medical services. They were being asked to pay the full amount they were responsible for at the time of their visit. After that, the doctor's office waited on delayed partial payment from the insurance company.

This is an issue in third-party-reimbursement situations, but not in pay-for service medicine like cosmetic surgery. In this field, a patient decides on a procedure they wish to have done, schedule their procedure, pay the costs, and have the procedure. Routine post-operative care is included, so there are no charges for the subsequent visits.

While it's nice to wait and pay for something later, payment at the time of service (for elective or scheduled care) is most logical and least expensive. It makes little sense for the practice to wait months and mail out bills for care patients received long ago. Contrary to the article's report, many medical offices figured this out years ago and follow it routinely. This reduces costs.

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