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Medical ‘Facility Fees’… Another Way to Stick-It to Patients

Medical ‘Facility Fees’… Another Way to Stick-It to Patients

“And that’ll be $150 for use of the room.” As if there weren’t already enough items on your medical bills to de-code and argue over with your insurance carrier, keep your eyes peeled for the “facility fee.” That’s right, a charge for using the room.

The facility fee apparently has been around for quite some time, only most of us were unaware of its presence because it was buried among the fees submitted to our insurance companies. With fewer insurance carriers covering the fee, it is being passed along to patients.

Patients are not always told upfront about the facility fees and learn of them only when they receive an itemized bill. Hospitals say they need the fees to cover costs. Shell-shocked patients and consumer advocates think it’s just another way to stick it to the patient.

According to a story on Kaiser Health News, patients are being charged the fees as the result of an obscure change in Medicare rules that occurred a decade ago. Because hospitals and hospital-based practices can bill Medicare beneficiaries this way, they must do the same for all patients. This applies to hospitals that own physician offices and outpatient clinics, but freestanding doctors’ offices and clinics are not permitted to charge these fees, which can range from $25 to hundreds of dollars.

Medical bills are already difficult enough to decipher. What, exactly, we’re paying for, and how much we can expect to pay, is a mystery to most of us before the fact. It’s not as if we can check out a menu of facilities, physicians, and procedures in order to comparison shop. It’s not as if we always have the time to even consider our options. We’re pretty much at the mercy of the facilities and physicians that happen to be “in-network” according to our insurance carriers.

The last time I visited the hospital, I didn’t even receive an itemized bill — just a grand total — apparently, you have to ask if you even want to take a look at the individual charges. 

Without comprehensive health care reform, we can expect more of the same. More hidden fees, higher premiums, higher deductibles… more stickin’ it to the patiens… and ever-more incentive to go without health care at all. 

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26 comments

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5:48PM PDT on Apr 4, 2015

Lots of extra costs that aren’t explained at the time of service. Then all of a sudden you get a bill.
Here’s a great example. In 2005, the Violence Against Women Act was amended to provide free medical forensic exams to sexual assault victims who go to the hospital—whether or not they choose to file a police report. However, in states like Louisiana rape victims are afterward presented with medical bills totaling thousands of dollars. VAWA’s provision covers costs related to “an examination of physical trauma, a determination of penetration or force, a patient interview and collection of evidence.” It doesn’t necessarily cover all the other procedures typically offered alongside the exam, such as tests for pregnancy and STIs, emergency contraception, post-exposure prophylaxis for HIV, or treatment for injuries sustained during the attack. But nobody explains that to the victims. Some victims were even billed for the cost of the emergency room visit itself. Talk about trauma!

5:12PM PDT on Apr 4, 2015

Disgraceful!

6:14PM PDT on Apr 3, 2015

It's amazing what they try to "tack on".

5:52PM PDT on Apr 3, 2015

If I wasn't sick before I read this I am now!
Thanks Ann.

2:39PM PDT on Sep 14, 2010

Interesting thast this article says the "use of the room fee" is legal only for hospital-associated facilities. I've been to the urgent care clinic in my area twice ... not connected with a hospital ... and both times was charged a use of the room fee. When I called the billing office to question this (how else can you be treated there if not in a room), I was given a gobbledygook answer, and the bottom line is if you acceot treatment there, you pay an additional room fee. So how and to whom does one report this if it isn't allowed by law for a non-hospital facility, assuming this article is correct?
medical device design

12:29AM PDT on Mar 26, 2010

If you are rich and can pay big bucks, you deserve to live. If you're too poor to afford insurance you can just go die somewhere in the street, preferably out of sight? Let's face it folks, it all hasn't moved too far from the days of noblemen and peasants has it? How can any decent-thinking person think that this sort of system is OK?

6:34AM PST on Nov 8, 2009

If a hospital is a "not for profit" facility then they shouldn't charge or if there is a charge it should be minimal which would be enough to cover food and the cleaning of the facility, like it would be if you were in a hotel. But to charge $2,000 a day is just way out of line.

8:11AM PDT on Oct 13, 2009

Another good example of why we need health care reform and especially we need universal health care, not health insurance coverage.

Until we ditch the insurance model I really do not see how there will be any meaningful reform. The insurance model is not working, we need extend medicare to cover all American citizens.

There are two amendments that support universal health care, the Weiner and Kucinich amendments. You can ask your representatives to support these in the House.

9:02PM PDT on Oct 11, 2009

That's the best one I've heard so far Tasha. Nasal Recovery!
When my husband went in for out patient surgery, we received some bills... and then we received some more bills... and then we received a check back from the hospital... and then we received some more bills... I'm still waiting for a bill from the person that emptied the garbage in his room, it's all so sliced and diced up to each person. The guy who takes the x-ray, the guy who processes it, the guy who reads it, etc. Maybe my music school should start doing that. Fee for the person who set up the lesson, fee for the room that the lesson is in, fee for the tuning of the piano, fee for the teacher, fee for use of the keyboard? Hhhmmmm, food for thought.

8:19PM PDT on Oct 11, 2009

As a former pt acct rep for a nonprofit hospital corporation, I can confirm that the facility fee includes the charges for nursing care. For whatever reason the govt allows hospitals to bill separately for MD care but not nursing care. The facility fee also includes the payment needed for utilities (light, water, heat, etc) and for payment on the facility and medical machinery itself. There is also the amount that the hospital must make up for its nonreimbursable charges for care, ie. the uninsured who cannot/will not pay. As the saying goes, "nothing is free". I do agree that itemized billing is a must and a patient right. It should be on the very first bill you receive, if no others.

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