Hospitals are beginning to ask patients to pay part of their bills before leaving the hospital. Some are asking that co-payments and deductibles, or at least a down payment, be made before elective procedures. The move is being made to reduce bad debts.

Many of hospitals' debts are uncollectible because the patients are too poor to pay. But a growing portion is due to insured patients who fall behind in payments on deductibles and co-payments that their policies don't cover. Hospital administrators are working to get the patient's portion of the bill, sometimes before the procedure is done.