New rip off - the facility fee

151949 · ‎03-09-2010

My DH saw a GI doc and was scheduled to have a colonoscopy. To be done at an outpatient facility next door to the doctor's office. Colonscopies are covered 100% by our insurance as they are also by medicare. So today they call and confirm the appt., and tell him he will need to pay 20% copay for anything they remove will make this an outpatient surgery - OK we know about that AND he will be required to pay a $295 "facility fee". So DH calls the insurance company and wants to know what that is and why we have to pay it. Apparentl;y there is a law now that allows any facility doing procedures to charge you a fee - over & above your insurance - for the use of their facility. Even though this is an in network facility the insurance does not cover this "facility fee". They did tell him it is generally only about $20 - $25 and that $295 was pretty excessive. This isn't just our insurance - it is all insurances.The facility fee is a patient responsibility. DH is on the phone right now to try to find somewhere with a more reasonable or no facility fee, because I went ballistic when I heard almost $300 for this.

cherry · ‎03-09-2010

It isn't fair. But I would count my blessings, that I have the resources to pay ,and the insurance to cover the bulk of this. There are many ,many ,people who are not so fortunate

happycat · ‎09-18-2010

Good Grief, it never ends....I've never heard of it either. That new law needs thrown out!

hoosieroriginal · ‎03-04-2012

What a ripoff? Don't they make enough money? Good to know though if I ever have outpatient surgery!

CelticCrafter · ‎03-09-2010

Wouldn't finding a new facility also mean having to find a different doctor?

NativeJax · ‎01-27-2015

Yes, this is a ripoff! They are just looking to get more money...pitiful

chickenbutt · ‎03-09-2010

I've never heard of this either, but it seems VERY wrong!

151949 · ‎03-09-2010

I would like to know why , when this law was passed , it wasn't on the news or anything. Imagine showing up for this thinking it is covered 100% by your insurance - then getting told this after the fact as you check out.

Mom2Dogs · ‎03-09-2010

@151949...I just learned about this new ripoff in December when the pain clinic I went to charged $167.00 for use of their facility inside my local hospital....

I was furious when I saw the charge on line so I called my insurance company and they explained it to me...one good thing is that my insurance picked up the fee for that charge, which I was happy about but I am still angry about this new way to $cre# the public.