Is this an example of a social cognition problem?

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I hardly ever go to the doctor, I mean have only been a handful of times in the last 15+ years so I'm not really familiar with how they do things these days. I didn't know they expect you to pay first now before you see the doctor. I just remember all the times I was growing up, that you paid after you saw the doctor.

The girl behind the counter was telling me how much it was going to be, and I thought she was just informing me so I would know the amount. Until my mom finally snapped at me that I needed to go up and pay.

Later my mom said, the way the girl kept saying what the amount was should have clued me in, and she was just watching me wondering if I was ever going to catch on. I really had no idea. I said, why didn't the girl just tell me, "You have to pay now." Am I supposed to be a mind reader? Or is this really something other people just figure out without having to be told?

Is this an example of what it means to have a social cognition problem?

No, I don't think this is an example of a "social cognition problem." What occurred was owing to your inexperience in present-day procedures. The receptionist should have informed you (nicely, of course) that you have to pay in advance immediately after you didn't pay in advance.

Possibly, you should have picked up the tone of the receptionist's voice--but this is not a social gathering, this is a doctor's office, where one is expected not to have to pick up on subtle nuances.

I'm sure, had this been a social gathering, that you would have known that you must discern subtle nuances.

I wish I knew you in person--maybe you're not as bad as you think. Maybe your mother's putting thoughts in your head, like my mother's always putting thoughts in my head--that I'm a social freak or something.

As long as you do your job well, make enough money, satisfy your customers, you're all right by me. You don't have to be this hypersocial butterfly. All have to have to do is pay taxes and die, and not purposely offend anybody.

I don't sense, in this case, that it is a sign of autism.

I've seen NT's be even more oblivious than you.

I think in cases like this they do not tell explicitly because if a client did know he was supposed to pay (and waited for some other reason), he might take offense as if they thought he was stupid.

Anyway, I think if you say sorry and explain that last time you had to pay at the end, that should be completely fine.

No, but it is an example of "getting your wires crossed". You and she simply had a different understanding of the same situation.

Ettina, I'm from the US, and I feel precisely the same way you do.

With regard to the scenario in the op, I think what went wrong is typical of people with autism. When I go anywhere like that (professional offices trigger panic) I rely heavily on planning and routine. The communication error occured because what she said was unexpected and strayed from the routine. Maintining the expected routine distracted you from her behaviour. Anyway that's my 2 cents.

This can be a sort of no-win situation, depending on the office staff person.

I have been in the same situation and thought, "does this mean that I should pay now?" and asked... and been told that I would be expected to pay after the visit, or immediately, but always with the suggestion that I should somehow magically just know what the procedure was.

I find the best approach is to be friendly and just ask a lot of questions:

Do I pay you know? Where do I go next? Is there anything I should do to prepare? How do I schedule a follow-up? etc. Sometimes they look at me like I am doing something off, but it's better to have answers than leave something undone or miss the point about paying, or whatever.

My ability to do this varies from day to day. If the appointment is on a good day, then it's easy. On a bad day I might have a hard time asking the right questions and they might have to tell me I need to pay.