More hospitals and surgery centers are requiring that patients pay for their procedures upfront, or they will postpone the treatment. Advance payment helps offset the cost of collecting afterwards, which saves a lot of money, say the institutions.

While federal law demands that hospitals take care of medical emergencies, procedures such as knee replacements, CT scans and births may be charged in advance, says The Wall Street Journal.

That means that people such as Heather Miconi, who works three jobs to earn her living, had to turn to a GoFundMe campaign to raise the money for her daughter’s much needed adenoid and tonsil surgery, says the Journal. The Merritt Island, Florida mom has too high a deductible on her health insurance plan to pay for the $2,000 procedure.

According to data collected by Kodiak Solutions, a healthcare and software company, a full 23% of patients pay in advance of their treatment, up from 20% in the same first quarter in 2020. The hospitals say that letting patients know ahead of time what they will expect to pay prepares them for sticker shock when the final bill arrives.

Paul Oster, a credit repair specialist, and founder of Better Qualified told a West Palm Beach, Florida news outlet that hospitals have been operating this way for almost a decade but now it’s becoming a trend.

“If you look at it, about 20% of the people that were polled haven’t paid their most recent medical bill, so this is a problem,” he said. “But this cannot all fall on the shoulders of consumers, especially right now.”

Experts say that before you pay, explore your options:

• If doctors and hospitals ask for money in advance, don’t assume you have to pay immediately. Negotiate a payment plan.

• Let them know if you can’t afford the cost. There may be financial aid or discounts available.

• Learn about charity care, and how some hospitals can write off your bill as part of their total amount of debt reported to the IRS each year. You can get free help to apply for charity care from an organization called Dollar For.

Remember that what you will pay for procedures depends on your health plan and your deductible, along with the negotiated price arranged between your insurance company and the hospital. Oster adds that people should start prioritizing medical savings, whether you have a health savings account through insurance or save on your own.

“Consumers have to be very proactive and plan for it,” he said.