I have a high-deductible insurance policy so I just pay up front for medical services (out of an HSA, but it's no different to the doc). Despite paying before t

I have a high-deductible insurance policy so I just pay up front for medical services (out of an HSA, but it's no different to the doc). Despite paying before the visit I got a bill after an appointment and then another warning that it was late. I called today after researching the CPT code and current billing schedule from my area to confirm that what they wanted was BS and as soon as she looked at my account she said "oh, yea they forgot to add the write off". Medical billing is so screwed up. I walk in and pay up front and it still somehow counts as a write off. A write off for what I am not sure, I am supposedly paying list price. I assume they really jack up the prices, have a pool for "uninsured" (regardless of merit) and then mark down from there to get a nice tax benefit because they gave a lot of "charity" care. I'd consider the $135 I paid for a < 10 minute visit to be more than ample compensation, whatever they're getting for the $90 write off should be fraud.