Can a medical facility put a hold on your card?

Prepayment and credit card holds are popular in urgent care clinics

Your Business Credit columnist Elaine Pofeldt
Elaine Pofeldt is a journalist whose articles on entrepreneurship and careers have appeared in Fortune, Working Mother, Money and many other publications. She is a former senior editor at Fortune Small Business magazine and an entrepreneur herself, as co-founder of, a website for independent professionals. She writes "Your Business Credit," a weekly column about small business and credit, for

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Question Dear Your Business Credit,
I took my daughter (19 years old) to an urgent care facility in our small town. They asked her for a credit card and then gave her paperwork to fill out.

The last page of the paperwork was a consent to charge the credit card whatever amount the charges came to after insurance. I refused to sign it and stated that I would pay for the service after she was seen.

They stated that they made a copy of my card and my written consent on that paper would ensure that they got paid. They put a $300 hold on the card. If the bill is less, they claim to refund it, but if it is more, they will charge whatever the amount comes to.

I again told them that I would not sign the paper and, since my deductible has not been met, I would pay for the service when the visit was complete. They told me that I either had to sign the consent, give them a check for $300 or $300 in cash before they would even see her. I walked out and told them I thought that was a shady practice.

Is this legal for them to copy a credit card and keep it on file and charge whatever they want after insurance has told them what they will pay? – Connie

Answer Dear Connie,
I can understand why you walked away feeling annoyed about the situation. When a child is being treated for an urgent medical situation, the last thing a parent wants to deal with is an unpredictable medical bill later. 

The way the urgent care facility handled your situation sounds insensitive, but was it illegal? I ran your question past Nasir N. Pasha, managing attorney at Pasha Law PC, which has offices in San Diego and five other cities. His firm represents small and medium-size businesses in California, New York, and Texas.

Pasha said the urgent care center’s policy is neither illegal nor shady.

“Urgent cares, unlike emergency rooms, are not obligated to treat patients who do not abide by their financial policy,” he said in an email.

Putting a hold on the card – like the $300 the urgent care center requested – prior to treatment is also permitted, he added. Doing so has become an increasingly common practice given the constant rise of deductibles, he added.

“It is not unlike a security hold from a hotel,” he said in his note. As Pasha also pointed out, getting a verification did not mean the claim would be approved. It was also possible the claim would be within your daughter’s cost share. 

Emergency rooms fall under the Emergency Medical Treatment and Labor Act, but urgent care practices don’t, he explained. This federal law requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.

“State law may make requirements more stringent, but I’m not aware of any state that would require any provider to provide non-emergency care,” Pasha wrote.

Some federal programs do prohibit or restrict prepayment deposits if, for example, Medicare is expected to pay, he wrote. But given that you did not mention your daughter receives her health coverage through a federal program, it does not appear that this is your concern.

So how can you avoid situations like this in the future? I’m the mother of four, and I know that some medical situations are out of our control. I’ve had to bring my own kids to urgent care facilities for everything from throat cultures to stitches and paid quite a bit for these visits. Then again, it was probably cheaper than a trip to the ER.

In some communities, you may be able to find a medical practice where doctors keep evening hours. That can help you avoid having to go to an urgent care facility.

Many older teens who are graduating from pediatric care haven’t yet found a primary care doctor, so helping your daughter find one may help you avoid last-minute scrambling to be seen. It’s hard to get a last-minute appointment with a doctor who has never seen you before.

Having a primary care doctor could save you from having to hunt down an urgent care provider as a last resort and worrying about what the charges will be in the end.

See related: Does a business have the right to charge a card on file?, 15 tips for paying high medical bills

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Updated: 03-24-2019