Great suggestions. We started collecting up front last year and some patients have a FIT. They get mean with the front desk staff, throw a fit in front of other patients, blame us, "it is all about money", "you are acting like a bank", "my other doctors do not do this". What really bothers me is when the insurance does not pay for certain service, the insurance's customer service sometimes tells them that the doctor did not bill it correctly or gave "wrong code". At the beginning of the year and with high deductible plans, it becomes very challenging.