Do you see your doctor in a hospital setting or at a private office? If it’s at the hospital, you could be charged with a little-known facility fee.
“It’s really not fair and nobody knows about it,” says Barbara Najarian of Lexington who recently had a routine dermatology visit at Beth Israel Deaconess Medical Center, “I was with the doctor for about 5 to 10 minutes. There was nothing special.”
The good news, her health was fine. The bad news came in the mail. In addition to the standard doctor’s bill, she received a second bill from the hospital. It was a facility fee for $44.74. It was not covered by insurance because Najarian had not reached her deductible. “I called the hospital back and I told the hospital I didn’t know about this fee. Did I sign something?”
According to a hospital statement, the charge represents “payment for the hospital’s cost of its facilities, nursing and staff salaries, maintaining medical records, and other similar costs.” Najarian was totally taken by surprise, “It never occurred to me that there would be anything but my doctor’s fee.”
And there’s another wrinkle to this story. Najarian only saw the dermatologist at the hospital because it’s close to her primary care physician. If she had seen the same dermatologist in his private office in Chestnut Hill, there would be no facility fee charged.
Beth Israel Deaconess is not alone. This is a common and legal practice of many hospitals. We found out that other Boston hospitals that charge this fee are Mass. General, Tufts Medical Center, Boston Medical Center, Brigham and Women’s Hospital and Children’s Hospital.
“None of us like to be taken by surprise,” says Alan Sager, a health management expert at Boston University School of Public Health.
He says more of us will be seeing these fees because deductibles are getting higher and higher. That also means we will have to pay them out of our own pockets. He says hospitals could be more upfront, “There should be a sign, a notice when we make an appointment or a brief mention over the phone.”
And in fact, that is now required at two Seattle hospitals which lost class action suits over these facility fees. As for Najarian, she’s changing her approach to her health care, “I will not go to the hospital again for the visit unless I’m up against the wall and I had no options.”
Another problem, the facility fee is not a set amount. It depends on the tests and the services you use and how long your appointment lasts. Experts like Sager say that while the fees seem unfair, the real culprit is the skyrocketing costs of health care. If hospitals eliminate the facility fee, they would have to make up the money by raising prices on other services.
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