I had a procedure done, last month, on my lower back for pain. Yesterday was my follow up visit. When I arrived, I told the receptionist I wanted to pay the bill I had gotten, the day before, for the procedure. The amount the receptionist said I owed was more than twice the amount shown on the bill. The receptionist said that was because the other Medicare payment was posted after my bill went out, and that the next bill I got would reflect that. When I said I only had enough money to pay the first bill, I was told I would have to sign a promissory note for the balance if I wanted to see the doctor. I refused, and stated that saying I had to sign the note, to see doctor, was a form of extortion, and that I was there to pay first bill in addition to my follow up appointment. Needless to say, this went around and around. I spoke to the office manager, as well, who stated it was their practice to get promissory notes for unpaid balances. I told them I was still in pain, and have not gotten any prescriptions from the doctor. My question is, can they force me to sign a promissory note for a bill, not yet sent by them, in order to see doctor?