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This Increasingly Common Hidden Fee Is A Nasty Surprise On Medical Bills

This increasingly common hidden fee is a nasty surprise on medical bills

When Jackie Thennes decided to switch doctors earlier this year, the hospital system in her Chicago, Il. suburb seemed like the natural choice. She’d been to the immediate care facility multiple times before for screenings, and the doctor was in-network.

But Thennes, who is 50 and looking for work, got a nasty surprise when the bill arrived in the mail: along with an anticipated charge for the doctor’s visit, she was also charged a “facility fee.” At $235, the fee was slightly more than the doctor’s visit itself.

Thennes tried to contest the charge with the hospital system, but to no avail. And while she said she won’t go to the facility again, she worries about getting hit with the same fee somewhere else.

This is “going to deter me from getting the medical attention I need,” she said. “I’m going to get sick just worrying about it.”

These kinds of facility fees are common at hospitals, where they help pay the hospital system’s overhead costs. But as doctors’ offices increasingly are being bought up by big hospital systems, patients are being charged facility fees of up to hundreds of dollars out-of-pocket without warning and without the ability to contest them.

Hospitals, in return, say these charges are key to their business model, since they must be available for “24/7 access to care for all types of patients, to serve as a safety net provider for vulnerable populations, and to have the resources needed to respond to disasters,” said industry group the American Hospital Association.

There’s also the argument that being part of a big hospital system gets patients better access to care — it might be easier to be admitted into the hospital if necessary, to get a second opinion or consult and share the patient’s health record, said Jack Hoadley, a research professor at Georgetown University.

But, “the question is, does that really materialize for you and your situation?” he said, especially if the doctor’s office is located several miles away from the hospital, or the patient has no need for those additional services.

A policy implemented this year, over industry opposition, may signal somewhat of a sea change. The Centers for Medicare and Medicaid Services will no longer pay facilities located off a hospital’s grounds the same as those based at a hospital, if the facility in question started billing Medicare after November 2015.

See: American health care is so messed up that a whole industry has…

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