Recently, Share Medical Center took steps to secure a better financial outlook for its operations by approving policy that requires patients to pay a portion of their fees upfront, prior to receiving outpatient services. And while the change in procedure has been acceptable to most customers, there are still a few questions worth clarifying for the public.

Will I owe everything upfront?

For people that have Medicare plus a supplement insurance or Medicaid (SoonerCare), no upfront payment will be collected for any service provided at Share.

If you have insurance, you will be responsible for a portion of your anticipated expenses at the time services are rendered. And, the upfront payment is only applicable to outpatient testing, outpatient surgery, and other outpatient procedures.

For people without insurance, payment in full may be expected, depending on the services received. And again, upfront payment is only applicable to outpatient testing, surgery and other procedures.

To find out an estimate of what you may owe, please contact the SMC business office. SMC staff may only be able to provide an estimate due to the nature of healthcare and the possibility that the results of the test you came in for prompt your doctor to order additional tests before you leave in order to recommend treatment. On the other hand, some tests may indicate that you are not an appropriate candidate for the procedure you were scheduled to have, in which event, your expense would be less.

Additionally, payment arrangements may be made with the business office and SMC offers a prompt payment discount for patients who pay their bill early. Under certain circumstances, financial assistance may be available.

What if I have an emergency?

It is unlawful to deny services to any patient in an actual emergency situation because of their ability to pay. And while this law is abused on occasion by patients who use the emergency department for their primary care, SMC does not plan to charge patients upfront for their emergency room visits at this time.

SMC does keep a close eye on emergency room abuse, and if triage personnel determine that a patient does not meet emergency room criteria, they may be referred to their primary care physician or to another outpatient provider. Triage is the process of determining priority of care for patients as a person having a heart attack will take priority over a person with a broken finger. A person who has had a sore throat for the past three days may be referred to an outpatient clinic as this is probably not an emergency.

Some emergency departments have started collecting payments prior to sending patients on their way. This has been considered by Share Medical Center, but such policy is not being implemented at this time – maybe in the future, but not right now.

Why has SMC decided to start requiring upfront payment for services?

There are multiple reasons for initiating this new collections practice, including the fact that up-front payment is becoming more and more prevalent with all sorts of healthcare providers. Physicians’ offices, chiropractors, therapy centers, and hospitals all across the country are making the switch to this type of policy to address a number of issues.

The biggest reason is that Share Medical Center is a small rural medical center that is highly dependent on its collections in order to sustain its operations. And while it would be false to say there has not been abuse of the system, the fact of the matter remains that people in general are having greater difficulty these days paying all their bills, including healthcare.

What is making it so difficult for people to pay their medical bills?

In addition to the increased costs of virtually every other good or service people purchase these days, there have been some definite trends in the healthcare industry that are contributing to this situation. Higher insurance premiums; if not higher premiums, then higher deductibles; and if a person is without insurance, medical bills can be very expensive.

Share is seeing a much larger number of patients going with high-deductible insurance plans. What this means is that they may be responsible for upwards of $1,000 to $5,000 or more before their insurance kicks in on many services and procedures. This is in sharp contrast to the $250 to $500 deductibles most people knew only a few years ago. And while the high-deductible plan will typically come with a lower premium, the premium for a high-deductible plan today is not that much different from the premium for a lower deductible plan from a few years back.

For many people in this area, healthcare costs come out of their disposable income, which for many doesn’t exist in the slightest. People are forced to decide between food on the table, gas in the car, clothes on their backs, and then whatever medical bills they may have.

And for others, many people don’t particularly plan for their healthcare expenses like they might for their children’s education, their retirement, or even their vacation next spring break. Healthcare is becoming more and more of an afterthought for many people who are either avoiding the reality of eventual illness or deliberately rolling the dice in hope that they don’t come down with something.

And it would be remiss not to mention that the costs of providing healthcare continue to rise all across the country.

Why is healthcare so much more expensive these days?

Most people would conclude that healthcare has always been a bit of a financial burden, but everyone can see that healthcare costs are nearly prohibitive these days. Many things are causing the rise in costs and there really aren’t any solutions within reach at the moment.

As one might expect, advanced technology, higher salaries, and greater overhead are the main reasons for the continuous increase in medical bills.

With regard to technology, Share has spent well over $1,000,000 on new equipment during the past few years in order to continue offering state-of-the-art services as often as possible. Medical equipment is often obsolete within four to five years; and for a rural facility such as Share, and for the business people out there, it is very difficult to cash flow the purchase of new equipment without significantly increasing the cost to the customer. But to the extent that technology is driving up the costs, technology is also helping the medical center to provide more types and volumes of services, which ultimately helps everyone.

The biggest challenges come in regard to staffing and regulatory mandates. Most people are aware that there are shortages in virtually every healthcare profession, i.e. nurses, doctors, therapists, etc… The simple rule of supply and demand forces the medical center to pay a premium for its workers. And while salaries have gone up, the impact of those workers has not become any more efficient thanks to the nationwide healthcare worker shortage. So, while people do feel the impact of increased wages in their medical bills, they aren’t really seeing any changes in their care – better or worse.

The last major reason healthcare costs are so high is that the government and other regulatory agencies have enacted a great number of unfunded mandates over the past few years. And while there are plenty of good reasons to take on such initiatives as privacy, customer satisfaction, and community protection measures like disaster preparedness and bioterrorism, these unfunded mandates create a financial burden that must be figured into the expense each patient pays, further increasing the expense of healthcare.

What can I do to keep my medical bills down?

Quite simply, take care of yourself! See your doctor for routine checkups and do what you’re told. For example, people who disregard medical advice like “lose weight” or “stop smoking” will eventually end up with a large emergency room bill, an ambulance bill, possibly a medi-flight bill, surgical bill, hospitalization bill, rehab bill and a home health bill to accompany their heart-attack, if they manage to avoid funeral expenses along the way.

If your doctor gives you medication for high blood pressure, take it or you may have all those bills mentioned above to accompany your stroke.

Share Medical Center might not have much to do if everyone took perfect care of themselves, but that might just be alright in the end.