The Professional Ethics of Billing and Collections

Medicine is a Profession on which physicians rely for their livelihood and patients for their lives. If physicians do not charge for services, they cannot survive. If patients cannot afford those services, they cannot survive. No wonder many physicians have long agreed that fees are “one of the most difficult problems . . . between patient and physician.” For years comprehensive insurance subdued this problem, but currently widespread underinsurance and consumer-directed health care are reviving it. Even as the ranks of the uninsured continue to increase,the latest hope for controlling medical costs requires insured patients to pay for much more care out-of pocket. The theory is that patients who pay will be good consumers and will shop for good health care at good prices. In this consumerist world, physicians must decide how to bill and to collect for their services. Medical ethics addresses these issues primarily as matters of professional etiquette and efficient business. Yet charging and collecting for health care unavoidably affects physicians’ duties to serve patients’ best medical interests. Therefore, these business practices merit ethical attention