A patient attempting to pay a routine copayment at his doctor’s was left seething after being refused the option to pay in cash while also being charged a fee for using a credit card.
The patient and original poster (OP), user l00sem4rble, recounted the incident on Reddit, explaining that he had visited his doctor’s office expecting to pay a $50 copay, only to be told the practice no longer accepts cash.
When he switched to a credit card, however, the total increased to $51.50 due to a 3 percent surcharge.
“I’m a pretty easy-going guy and don’t like to get all Karen toward service providers, but I told her that I need to voice my opinion as a customer,” the OP wrote.
“I said, ‘I’m not taking this out on you personally, but your company’s policy is absolutely infuriating. I can understand if you want to charge a surcharge for credit cards, but you can’t do that and refuse cash. That’s just ridiculous.'”
In the end, he left and asked the woman to send him a bill.
“I’m sure it’s going to be much better for them to have to mail out a bill and then receive a paper check in the mail, which then they have to take to the bank,” he added.
The situation reflects a growing shift in health care billing practices as more offices move toward digital payments while also trying to offset processing fees.
According to a blog published by the American Academy of Professional Coders (AAPC), “Charging patients a fee to use a credit card is referred to as ‘surcharging.’”
The same source notes that “in states that permit surcharges, amounts cannot exceed the cost of the processing fee (generally 3 percent).”
A separate industry analysis from Practice by Numbers states, “[Surcharging] is allowed in most of the US, but it can bring up ethical issues in healthcare.”
The article adds that “patients already face high medical costs. For them, surcharges may feel like extra money they have to pay, making it harder to get the care they need.”
Reddit Reacts
In the Reddit thread, some commenters questioned whether the combination of policies described by the OP could violate state rules.
“Check whether this is illegal in your state. In some states, you can only charge a surcharge on credit cards if there is a non-surcharge option,” one Reddit user wrote.
“Otherwise they need to just eat the credit card fee or, presumably, just charge more to cover it.”
The same contributor added that regulations can vary, noting that in certain states, businesses must provide a legal tender option, such as cash or money order, to avoid excluding customers without access to banking services.
Others focused less on legality and more on convenience, with one commenter remarking, “We’re going to have to start carrying around checkbooks again.”
Healthcare providers have increasingly adopted card payments and digital systems since the pandemic, often citing faster processing and reduced administrative costs.
The AAPC article explains that electronic payments can eliminate mailing expenses and streamline billing, though it also warns that transaction fees can cut into provider revenue.
At the same time, industry guidance stresses the importance of transparency when fees are passed to patients. Practice by Numbers states that providers should clearly explain surcharges and display them prominently to avoid confusion or frustration.
Newsweek has reached out to l00sem4rble for comment via Reddit. We could not verify the details of the case.
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