Medical Building Facility Fees

Posted on March 21, 2008 by Dr. David Edward Marcinko MBA

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Surcharging Startled Patients

[By Staff Writers]skyscraper 

As all print subscribers to Healthcare Organizations [Financial Management Strategies], and regular readers of the “Medical Executive-Post” are aware, medical billing is complex enough without throwing another factor into the mix. 

Medical Facility Fees?

Increasingly, however, it seems that patients are being caught off guard by a new “facility fee” for visiting doctors who are based in a hospital-owned building. The issue is not exactly new, but it is expected to become more contentious as patients use high deductibles imposed by consumer directed health care plans [HD-HCPs]; according to a report by FireceHealthcare. 

Those facilities, like Milwaukee’s Froedtert & Community Health who charge the fees, usually post warning signs although their patients often end up arguing with insurance companies over payment.

Making the financial sting even worse, some insurance companies treat the facilities fee at the doctor’s office as the first dollar of what can be a high hospital deductible, rather than applying it to a physician deductible. 

And, the fees vary widely, from a relatively small $20 or $30 to a few hundred dollars.

Assessment

What’s even more insidious is that some hospitals are already charging patients not only for professional medical services, but also a facilities fee for physical use of the building.

Conclusion

This historical review paper provides a retrospective review of IRs and implications for modernity.

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17 Responses

  1. Edward, on March 21, 2008 at 12:37 AM said:

    More on Hospital Facility Fees …

    Did you know that Wisconsin legislator Rep. Charles Benedict (D) introduced a bill that would require physician offices to disclose facility fees in advance? The bill passed the state Assembly in March, and now Benedict hopes to find a co-sponsor in the state Senate.

    And at least two facilities, Seattle’s University of Washington Medical Center and Virginia Mason Medical Center, settled law suits in 2006 contending that patients should have been warned about much-higher charges by affiliated clinics.

    And so, just when you thought the industry was smelly-enough; it becomes even more malodorous; or is it just my nostrils?

    -Edward

    Like

  2. Tracey L Croisier, on August 28, 2008 at 7:06 PM said:

    I’m stunned into stupid silence. I just got off the phone with Evergreen’s billing office. Seems that for each dollar I’ve paid to a doctor, there’s at least another dollar that I’ll need to fork over to Evergreen for “facility fees.”

    I’m pregnant with twins and have had ultrasounds every month and monthly doctor’s visits. I’m in my final trimester and am supposed to now see the doctor every two weeks and ultrasound every two weeks.

    So if I’ve done the math right, there’s this mysterious ‘facility fee’ bill looming that will likely top *five thousand dollars.* Almost seems like it would be cheaper to induce labor early to save myself a couple of grand. And, no, I have received no prior warning of said fees.

    Tracey

    Like

  3. Jodi, on September 7, 2008 at 12:11 PM said:

    Does anyone know what we can do to eliminate these facility fees; is this legal and how can we get around it? I am very nervous about all this.

    Thanks for anything you can advise.
    -Jodi

    Like

  4. Dana, on October 2, 2008 at 11:41 PM said:

    Stunned,

    I am so completely stunned that my jaw is on the floor!

    I had never heard of “facility fees”, before! And, what is worse, my hospital bill does not list the fee as a “facility fee”; it “hides” it in another spot. I had lap-band surgery and the “facility fee” is hidden in the implant fee @ $9405.20.

    Why doesn’t Evergreen just list a “facility fee”? I am so mad right now I could just scream! Maybe if I had warning of a “fee” I wouldn’t be so mad, or when I disputed the bill, if the customer no-service clerk had told me about the fee.

    I will never recommend Evergreen Hospital to anyone!!

    -Dana

    Like

  5. Martin, on March 3, 2009 at 2:52 PM said:

    Jodie, Tracy and Dana

    According to Karen Caffarini, of AMNews, on March 2, 2009, real estate analysts say that even though the medical offices sector is still considered healthy in the mostly comatose commercial real estate market, it is beginning to show signs of fatigue. While that might mean trouble for physicians who own or want to own medical office buildings, those who lease might be able to turn sagging fortunes to their advantage.

    Any other thoughts on this topic; or on health facility fees?

    Link: http://www.ama-assn.org/amednews/2009/03/02/bisc0302.htm

    Martin

    Like

  6. Kristin, on March 17, 2009 at 10:23 PM said:

    I am post-op for thyroid cancer which I had done at Geisinger Medical Center, in Danville, PA on 2/3/09.

    I had my larynx (endoscopy) checked in the office by a resident to make sure I didn’t have cancer wrapped around my vocal cords. And, now I am getting charged a facilities fee for that visit on 1/26/09 – which is total bull considering it was done right in the doctor’s office. The fee is $100. I will be fighting this fee; especially since I had the procedure done in 2003 and in another office.

    Kristin

    Like

  7. Harry, on June 18, 2009 at 11:09 AM said:

    Edward, Tracey, Dana and all ME-P Readers,

    The Cleveland Clinic is “doing it.”

    Despite Cleveland Clinic CFO Steven Glass’s assertion that without facility fees “we wouldn’t be able to stay in business,” many patients are becoming very upset at the thought of paying more money, the Cleveland Plain Dealer reports.

    http://blog.cleveland.com/metro/2009/06/patients_fume_over_cleveland_c.html

    Harold

    Like

  8. Jodie, on December 15, 2009 at 1:05 PM said:

    Medical Real-Estate

    For doctors who rent office space, some experts advise negotiating lower rates or seeking various perks. If you own and lease space to others, customer service is increasingly important.

    http://www.ama-assn.org/amednews/2009/12/14/bil21214.htm

    Jodie

    Like

  9. Barbara, on December 18, 2010 at 3:40 PM said:

    More on “Facility Fees”
    http://www.post-gazette.com/pg/10351/1111342-28.stm
    Shameful!

    Barbara

    Like

  10. Nancy, on May 24, 2012 at 10:10 AM said:

    Patients sue Tenet Healthcare for hidden facility fees

    Dr. Marcinko – Did you know that a class action lawsuit accuses two Tenet Healthcare hospitals of including sneaky “facility fees” in its bills, according to the the St. Louis Business Journal.

    http://www.bizjournals.com/stlouis/news/2012/05/21/thomas-files-class-action-suit-against.html

    Nancy

    Like

  11. Anita, on May 7, 2014 at 12:17 PM said:

    How recent changes are leading to hidden hospital fees

    Daniel Chang wrote a piece for The Miami Herald on some of the hidden hospital fees that can take patients by surprise – and which insurers don’t necessarily cover.

    http://healthjournalism.org/resources-articles-details.php?id=288#.U2okW5VOX5p

    Anita

    Like

  13. Ingrid, on December 17, 2014 at 4:08 PM said:

    Facility fees pressuring physicians to talk costs with patients

    The rising price of healthcare and the increasing use of facility fees is forcing physicians to confront costs when treating and referring patients.

    http://medicaleconomics.modernmedicine.com/medical-economics/news/facility-fees-pressuring-physicians-talk-costs-patients

    But all costs … would be more transparent.

    Ingrid

    Like

  14. Litha, on December 17, 2014 at 8:13 PM said:

    Hi All,

    Can anyone tell me if facility fees go toward the annual deductible amount in a private HSA, PP-ACA or traditional group health insurance plan?

    Litha

    Like

  15. Barbara, on April 7, 2017 at 7:20 PM said:

    Facility Fees

    MEDPAC has long argued for “site neutral payments,” but the hospital lobby has deafened Congress to the recommendations of its own commission.

    The American Hospital Association opposes MEDPAC’s recommendations on several grounds, including facility fees are justified because they create the incentive hospitals “need” to shore up “loss leaders” like the ER, where they are obligated to treat everyone, regardless of ability to pay.

    Hospitals also say the money helps make up for low government reimbursement rates and pay expenses outside of patient care, ranging from electric bills to hospital administrator salaries.

    Barbara

    Like

  16. Litha, on April 27, 2019 at 12:10 PM said:

    Fees

    Hospitals Chafe Under Medicare’s New Payment Rule For Off-Campus Clinics:
    https://khn.org/news/hospitals-chafe-under-medicares-new-payment-rule-for-off-campus-clinics/

    Litha

    Like

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