For the sake of simple math, let's say it costs a clinic $700 to do a procedure plus the cost of overhead to keep their doors open. Health insurance companies only pay 70%, $490. The clinic loses money per procedure. To get the full $700 from the insurance company, the clinic has to state that their service costs $1,000.

If a patient comes in with $700 in cash and a "discount card," the clinic goes though a song in dance where they will perform this "$1,000 procedure" for only $700.

Jeanette Isabelle