'Facilities fees' for doctor visits startle patients

Healthcare billing is complex enough without throwing another factor into the mix. Increasingly, however, it seems that consumers are being caught off guard by a new bill--a "facility fee" for visiting doctors based in a hospital-owned building--which these days, they're usually expected to pay on their own. The issue isn't new, but it's hotter now that many patients struggle with high deductibles imposed by consumer-directed health plans.

As readers of FierceHealthFinance probably know already, patients who come into a hospital are billed not only for professional service, but also a facilities fee for use of the building. However, increasingly, hospitals are also imposing such fees for doctor visits in their buildings, something that insurance often refuses to cover. The fees vary enormously, from a relatively trivial $20 or $30 to a few hundred dollars.

While doctors' offices that charge such fees, such as Milwaukee's Froedtert & Community Health, usually post signs warning patients that a facility fee will be assessed, consumers aren't sure what the signs mean, and often end up arguing with insurance companies over the unexpected bill. Making the sting worse, some insurance companies treat the facilities fee at the doctor's office as the first dollar of what can be a high hospital deductible, rather than applying it to a physician deductible.

One Wisconsin legislator, Rep. Charles Benedict (D), has introduced a bill that would require physician offices to disclose facility fees in advance. The bill passed the state Assembly this month, and now Benedict hopes to find a co-sponsor in the state Senate. And at least two facilities--Seattle's University of Washington Medical Center and Virginia Mason Medical Center--settled suits in 2006 contending that patients should have been warned about much-higher charges by affiliated clinics.

To learn more about this issue:
- read this Milwaukee Journal Sentinel piece

Related Article:
Clinic "facility fees" spark legal battles. Report

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