FACILITY CHARGE: Healthcare Service Fees

Posted on March 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITION

By Staff Reporters

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FACILITY CHARGE DEFINED

Classic: Service fee submitted for payment by a healthcare facility, such as a clinic, hospital or ambulatory care center.

Modern: Facility fees are expenses charged by hospitals to cover their overhead – the funding needed to keep the lights on, machines running, and doors open, etc. People who receive outpatient care at hospital-owned buildings are charged a facility fee, in addition to treatment costs and fees charged, individually, by doctors.

Examples: How to Fight Facility Fees:

  • Check with your health agent or insurer. Many insurers don’t cover facility fees or cover only a portion. 
  • Talk to your doctor. It’s hard to tell whether a facility is hospital-run or whether your doctor works for a health system.
  • Negotiate hard.

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BEWARE: Junk Health Insurance and Medical Billing Fees

Posted on June 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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President Joe Biden is cracking down on what the White House calls “junk” health insurance plans – namely, less-robust and short-term coverage that the Trump administration expanded as a cheaper alternative to Obamacare AHA plans.

Biden announced a draft regulation which, once finalized, would limit temporary plans to four months instead of the current three-year maximum. It would also require more disclosure on coverage limits.

“This rule would help make these plans fairer and help ensure that consumers know what they’re getting when they sign up for insurance,” said White House domestic policy advisor Neera Tanden. “When they don’t know what they’re getting and get these gigantic bills, they can feel like it’s a scam.”

CITE: https://medicalexecutivepost.com/2022/03/04/podcast-the-no-surprises-medical-billing-act/

The president also announced new guidance on medical billing stemming from 2020’s No Surprises Act. The guidance would limit the ability of insurers that contract with hospitals to claim provided care was not in network and have customers pay more money. Health plans also would need to disclose facility fees that are increasingly charged to patients and can surface as an unexpected cost in a medical bill.

CITE: https://www.r2library.com/Resource

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