A visit with your doctor could carry a hefty ‘facility fee’


Hospitals are borrowing a page from banks to get extra money from patients

Bank fees can be a nuisance but they hardly compare to fees hospitals have begun to charge patients – fees often totaling hundreds of dollars.

If you’ve carefully examined your bills, you may have noticed that even a routine visit to your doctor can carry a “facility fee,” a charge for the use of the doctor’s office. Data gathered for a report in the Wall Street Journal show that the fees often began to appear after a hospital acquired a medical practice.

The fees can be attached to the most routine medical services, things like colonoscopies, mammograms and heart screenings. As an example, the Journal interviewed a patient who sought treatment at an eye, ears and throat clinic in Ohio. The bill for services was $348 but the Journal reports the fee was $645.

Can there be any justification for that? If you ask hospital administrators, they say the fees help cover the costs of abiding by increasing federal regulations. Jason Kleinman, director of federal relations for the American Hospital Association, told the Journal that the fees also help offset the spiraling costs of expensive services like neonatal care. 

Patients with insurance might not encounter the fees, it’s mostly those paying for services themselves. Medicare advisers told the newspaper that Medicare likely paid $6 billion in facility fees in 2021. However, not all insurance covers the fees, or may only cover a portion of them.

Can you avoid these fees?

The Alliance, which helps self-funded employers design custom provider networks, says the facility fee issue might not be so cut-and-dried. 

“A facility fee is a charge that you may have to pay when you see a doctor at a clinic that is not owned by that doctor,” the group says on its website. Facility fees are charged in addition to any other charges for the visit.

“Facility fees are often charged at clinics that are owned by hospitals to cover the costs of maintaining that facility. Facility fees can range from $15 to hundreds of dollars, depending on the service you receive.”

Patients have a couple of options but awareness of the fees is essential. When you make an appointment at a facility, ask if you will be charged a facility fee. 

If there is a facility fee and you don’t want to pay it, ask if the doctor can see you at another location that does not charge the fee.  Before confirming the appointment, it’s a good idea to ask how much the fee is and whether your insurance will cover any part of it.

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