Community Chat

[Just Bling]

For this procedure, I would never agree to any "facility" to get this done, I would choose a hospital environment since they put you completely under.

Sorry, I didn't know you were speaking regarding Medicare, don't know anything about that.

[Abrowneyegirl]

The facility charge in my area is not new, about 5 years ago I was charged a Facility Fee of $80 for seeing a dermatologist at a medical office associated with a major hospital.

He MD washed his hands and looked at my skin (arms and legs) asked me if I had any suspicious moles and left.

Co-pay $35 for a specialist

Facility Fee $80

I was told that everyone that was private pay or private insurance was charged a facility fee for any appt that uses their facility to cover overhead.

The only ones exempt for paying are those on government insurance.

I told them since the fee was NOT disclosed until AFTER the fact I wanted to make payments.  I made them send me a monthly statement for 12 months until I paid it off.  

[Abrowneyegirl]

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@Just Bling wrote:

For this procedure, I would never agree to any "facility" to get this done, I would choose a hospital environment since they put you completely under.

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For many who have private insurance this is not an option unless you can pay a huge bill.  It is cost prohibitive to go to hospital for something that can be done at an outpatient facility for less that a quarter of the price.  Insurance companies are NOT going to foot the bill for personal preference of going to a hospital.

[Lipstickdiva]

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@Abrowneyegirl wrote:

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@Lipstickdiva wrote:

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@Lynnster67 wrote:

Also, if you are not officially admitted but are just "under observation" you get stuck w/big bill.  (This happened to my grandmother so I raised holy heck w/the insurance contact at my grandfather's former employer.)

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If you are in for under 24 hours and considered under observation, I know they charge for some things at a much higher rate.  We ran into this with my DH.  Initially he was in under observation and I was told to bring in any meds that he takes so they could give them to him because if they had to get them from the pharmacy, the price was ridiculously high.

As it turns out, he turned into a full admission and now our insurance company rejected the claim filed by the hospital, stating it wasn't medically necessary for him to be admitted. 

I was in the hospital about a year ago, under observation, and didn't pay a dime.

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You can be UNDER OBSERVATION for up to 3 days.  

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Apparently either not with this hospital or not with our insurance.  They told us it's 23 hours and under.

[Lipstickdiva]

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@Just Bling wrote:

For this procedure, I would never agree to any "facility" to get this done, I would choose a hospital environment since they put you completely under.

Sorry, I didn't know you were speaking regarding Medicare, don't know anything about that.

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When I had surgery, it was still billed as a "facility" fee even though it was in the hospital. 

[bonnielu]

Never ends.  Different set of standards, government, medical facilities operate under different rules.  If we tried it we would be arrested for some sort of scam.  

[SahmIam]

It's interesting.....I think this fee has been around for a long time but how it's billed OR the fact that due to newer billing techniques, the public is now seeing how hospitals/facilities paid the bill to cover the care of those who either don't have insurance or fail to pay their bill.

Like I said, I've seen this/paid this for at least a decade and the first time I saw it, I called the hospital and complained. I was told that "just walking the hallways to see the doc means you get charged this fee".

NEVER forgot that!

[151949]

As I said before - my DH had 2 cataract surgeries last year at an outpatient surgi center and we did not get charged this fee.100% paid for - we still have the exact same insurance.

[Pitzel]

@151949

My internist's office just told me that they are going to charge $200.00 a year for filling out paperwork, doctor talking to patients on the phone and other miscellaneous things.  I think this is absolutely ridiculous.  And insurance doesn't cover this.

[Lipstickdiva]

As an aside, my DH's doctor submitted a separate charge to read an EKG report.  He didn't include it with his other services.  My insurance won't pay for that.