I work for a multi-physician practice that insists on charging patients who have co-insurance a percentage of the anticipated charges before they see the doctor, knowing full well that the actual patient responsibility will be less than half of what they have collected. They justify this with the rational that it is better for their A/R to collect extra and refund it later (which takes 3-4 months) than to have patients owing them money. I feel this is unethical at the least but they are not open to discussion. How do others feel about this and does anyone know of any documentation on this topic that I might present to change their minds?