[asphaltgambler]

I know this very well as my wife was in the billing / coding aspect of the industry on behalf of the medical providers. She now is on the people side as a surgical assistant, much more rewarding.

Ethically, they / them should treat the patient and resolve the issue, hopefully. That patient is classified as 'Self-pay'. Some providers or the facility will require some up-front payment in cash or check prior to any surgical procedure. Then a monthly repayment plan that both parties agree to and sign off on.

On medical billing, know that 'Self-pay" billing rates are the highest. Think in terms of paying full retail + 20% or more for a service or product. Or like a buy-here-pay here used car dealership in terms of the $$ structure on the 'deal'. In this example you're going to pay $6K for a $3500. car.

Most Physicians and facilities understand that fully collecting on self-pay cases is a long and tedious process and that some - they will never collect and use that to offset tax liabilities. That portion is sold off for pennies on the $ to collection agencies.