You think interest on your credit cards is steep? Take a second look at your doctor bills.

Some area physicians are using high interest rates and aggressive collection tactics to battle a mounting deluge of delinquent accounts they say is caused by a national recession and receding employee benefits.In short, patients responsible for a larger portion of their bills are taking longer to pay them - and doctors are tired of waiting.

A group of University of Utah pediatricians recently decided to raise the interest on delinquent accounts to 18 percent and turn accounts over for collection after 90 days instead of the former 120 days. The physicians also practice at Primary Children's Medical Center but bill separately from either hospital.

"I think it's just good business," said Dr. Richard A. Molteni, acting chairman of the U.'s department of pediatrics and acting medical director at Primary.

Bryner Clinic, home of 26 multispecialty physicians, began chasing delinquent accounts more aggressively a year ago. Since then, the clinic's percentage of past-due accounts has dropped, said Michael E. Margetts, business manager for the clinic.

The clinic also took steps to prevent accounts from becoming delinquent. "We are asking patients to pay at the time of their first visit and we are sending them reminders more frequently when their accounts are past due," he said. The clinic is more closely screening new patients.

Like the U. pediatricians, the Bryner Clinic charges 18 percent interest on accounts 60 days past due.

Why 18 percent? "Check with Visa," Molteni said, explaining that physician interest rates follow credit card rates.

For several years, Intermountain Health Care hospitals have been charging 18 percent interest on accounts after 65 to 70 days, said John Taylor, spokesman for IHC.

"It is getting more difficult for us to collect," Taylor said. "When the economy turns down, it becomes more difficult for people to pay their bills."

And those bills are getting larger as more employers cut back on employee medical coverage, forcing employees to pay for an ever-increasing slice of the health-care pie.

"Employers are building larger deductibles and co-payments into their health-care plans," said Richard A. Fullmer, comptroller at the University Hospital.

Additionally, 250,000 Utahns have little or no insurance, according to state figures.

Delinquent accounts - coupled with inadequate Medicare and Medicaid payments from the government - put some hospitals under crushing financial pressure.

"Our accounts receivables at the end of March was $52 million," Fullmer said. "We have written off several millions of dollars owed us by self-paying patients during the first nine months of our fiscal year."

Despite the financial crunch, the U. Hospital charges no interest on delinquent accounts. The hospital doesn't see high interest rates as a solution to delinquent bills. "If someone can't pay a $20,000 hospital bill, a high interestrate will make the problem even greater," he said.

Molteni disagrees. He equates medical care with credit-card use. If a consumer builds up a high credit balance, he pays high interest. If he racks up a high medical bill, he pays high interest.

"Unfortunately medical care is a luxury. It shouldn't be in this country, but it is," Molteni said.

Hospitals and physicians say they work with patients who let them know early on that they can't pay their bills. Some hospitals have in-house financing. The U. charges 12 percent interest on financial arrangements made through their in-house loan office.

Molteni said that although his group charges 18 percent interest on delinquent accounts, the group also offers payments plans to struggling patients that carry no interest.

When all else fails, attorneys representing doctors and hospitals take patients to court.

"Unfortunately, we are in court a lot," Fullmer said.