Big corporate American hospitals now want you to pay up front for surgery

• Some US hospitals are demanding payment for non-emergency surgeries up front.
• It comes as hospital systems and corporate entities buy up medical practices nationwide.
• But for some patients, paying up front is not an option.

Getting surgery is getting harder in some American hospital systems.

In the past, medical centers have broadly provided procedures first and settled the bill with patients later — something they are legally required to do in emergency cases.

Now, in non-emergency cases, some hospitals want to be paid up front before they operate, and customers — ahem, patients — are not thrilled, The Wall Street Journal reported.

A surgical center in Flordia now owned by UnitedHealth, a healthcare insurance giant, told the Journal that billing patients in advance informs them of the expected cost. However, forcing patients to pay in advance also relieves companies from the cost of having to track and bill patients later on.

This shift comes as insurers, hospital systems, and private equity firms are quietly but efficiently buying up medical practices across the country, Business Insider previously reported.

Over three-quarters of doctors in America are now employed by a hospital or corporation and, as of January, more medical practices were owned by corporations than hospital systems, according to research from the Physicians Advocacy Institute.

Some medical providers fear the corporatization of healthcare could have a detrimental impact on patients. The new "pay-first, cut-later" policies at some medical practices may be an example of that negative impact, forcing people suffering from a medical condition that's severe enough to require surgery to scramble for funds to obtain the procedure.

In Tennessee, a hospital system overcharged 59-year-old Blake Young by over $2,500 for a heart scan, Young told the Journal. He had paid up front at the hospital's request and later found out he was charged too much for the service. He wrestled with the hospital for months to secure a refund check.

"It's not unlimited funds," Young told the Journal, noting he would use the refund for future unexpected medical bills. "They do run out."