I read the health insurance fine print (Blue Shield of California), and it said that while doctor’s office visit copay ($40 at the time) is expected to be paid at the time of visit, any remaining balance due can be paid after insurance is billed. So when the receptionist pressed me for full payment at time of service, I declined, saying I would pay the copay, but wait until the EOB before paying additional. The receptionist confessed she was told by the office manager to press patients for full payment so that collecting payments afterwards wasn’t so onerous. I shrugged and said I always pay my bills.
I called my health insurance customer service a few weeks later and asked if the service provider could cancel my appointment if I didn’t agree to pay the full amount at the time of the visit, beyond the required copay. She asked if the provider was in-network, and I confirmed they were. She then explained that the contract with an in-network provider is that they cannot insist the patient pay anything beyond the contract copay at the time of visit. And for lab services like Quest Diagnostics (another service provider that tried insisting on upfront payment at time of service), they cannot collect anything upfront at all, and they must wait until the claim is processed before billing the patient. But, if the provider is not in-network with your insurance, these rules don’t apply.