Healthcare - new charges - a Facility Fee

by sammielee24 14 Replies latest jw friends

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  sammielee24

  LA Times>

  Possibly coming soon to a doctor's office near you: a little something extra on your bill, not covered by insurance -- a nifty number known as a "facility fee." What is it exactly? Here's a fun experiment: Ask five medical professionals. Most likely, you will get a variety of explanations, all guaranteed to make you respond, "Huh?"
  
  "Healthcare billing is complex enough without throwing another factor into the mix," writes the website FierceHealthFinance. "Increasingly, however, it seems that consumers are being caught off guard by a new bill -- a 'facility fee' for visiting doctors based in a hospital-owned building -- which these days they're usually expected to pay on their own."
  
  I definitely was caught off guard when I checked in to see a specialist in a Cedars-Sinai Medical Center building in Los Angeles and was told to pay a $75 facility fee. When I asked what that meant, the receptionist explained that this was a fee being levied to cover the wear-and-tear I would inflict on the office.
  
  Or at least I think that's what he said. Though I already was somewhat dazed by my medical problem, I did grasp that the extra charge was being imposed simply because I was in the house.
  
  What if I promised not to touch anything? Could the fee be waived? I didn't even need to sit down. I could stand in the corner, on my newspaper.
  
  No dice.
  
  So I handed over my credit card, then went into the ladies' room. I entered a stall and discovered -- no toilet paper! Excuse me, but if you're going to charge patients a facility fee, then how about maintaining the facilities?
  
  My next encounter with a facility fee took place when I called UCLA to make an appointment for a routine check-up with a new doctor. The appointment secretary said this doctor had offices at the UCLA buildings in Westwood and Santa Monica. Which did I prefer?
  
  Westwood, please, I said. In that case, she replied, she needed to inform me that there would be a facility fee of $150 to $300, which would not be covered by my insurance.
  
  How about the doctor's office in Santa Monica? Would there be a facility fee there? Nope.
  
  Gee, let me ponder this for a while. Hmmm . . . I'm thinking . . . make the appointment in Santa Monica.
  
  Why, I wondered, would the fee range from $150 to $300? Based on what? Perhaps the patient's weight -- the logic being the heavier you are, the more damage you'll inflict on the carpet? Well, I just lost 5 pounds, so how about a discount?
  
  What if I tiptoe? Bring a little broom with me and sweep up after myself? Carry some cleaning spray and erase any marks I make?
  
  A few days later I received written confirmation of my appointment. This included a warning, in screaming caps: "MAKE SURE ALL FOLLOW-UP CARE IS IN THE SANTA MONICA OFFICE," rather than Westwood, to avoid a facility fee.
  
  Isn't this a tad passive-aggressive? "We have an office for your convenience in Westwood, but don't even think about visiting it!"
  
  It's not hard to imagine how expensive it is to run a medical office these days. I get that. But what I don't get is why patients are being asked to pay extra when we seek care in a particular building.
  
  Frankly, I wouldn't resent so much paying an "outstanding doctor fee" or a "help pay off the medical school loan fee." But a "facility fee"? That just seems wrong.
  
  Dwass is a freelance writer in Los Angeles.
• 

  JeffT

  These kinds of fees have been common in commercial real estate under a variety of names for some time. They may or may not be passed on to the customer directly, depending on the business. I've managed medical buildings, they are very complex structures and cost a lot to run.

  I am a bit surprised that they are so blatant about passing the cost on to you.
• 

  restrangled

  Surprise!!!! They have already worked their way around congress and the lame axx health bill before it ever goes into effect, in fact, it gave them the idea how to charge more. Next it will be parking fees, pay toilets, and maybe like lawyers will charge by the minute fee for phone calls.

  It's all completely corrupt.

  r.
• 

  sammielee24

  One of the worst abuses of the private insurance industry is known as recission, where insurers decide to revoke the coverage of their customers for frivolous reasons. The Los Angeles Times reports today that one of the nation’s largest insurers, Blue Shield of California, has “notified [its] policyholders” that their coverage could be “immediately dropped” if they miss even a single payment:

  Amid a national debate on how to make the healthcare system friendlier and more accessible, and as millions of people grapple with the loss of jobs and homes, what does insurance heavyweight Blue Shield of California do? It decides to take a key benefit away.

  The company has notified individual policyholders that their coverage could be immediately dropped if they miss a single payment — or so it seems. Blue Shield says in a letter to customers that they can reapply for insurance, but with potentially higher premiums and stricter conditions.

  Thankfully, a California law that mandates minimum grace periods and a decision by the company that will allow for a 28-day grace period will keep Blue Shield from immediately dropping people from coverage, as their letter threatens. The LA Times goes on to note that the the company’s pronouncement comes “after last year’s announcement that Blue Shield and Anthem Blue Cross agreed to pay a total of $13 million in fines after cancelling the policies of more than 2,000 Californians after they became ill .”..........LA Times
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  Elsewhere

  This is why health care should be regulated in a manner similar to utilities.

  As an example: In Texas we had the great idea to deregulate electricity and encourage free-market competition between several electric companies.

  The result:

  • Texas now has some of the highest energy costs in the United States.
  • The cheapest electricity is about 10 cents per kilowatt hour. Green Mountain is about 14 cents.

  Utilities and Healthcare should both be regulated to ensure fair prices and reliable service.
• 

  JeffT

  We have regulated utilities and insurance in Washington. Utility regulation seems to work, most of the time. Home owners and auto insurance work OK, at least I can choose between competing companies trying to get my business. I hate what has happened to health care. I may be wrong, but it seems to me that the problem is that the end providers and consumers have been cut out of the process. The insurance companies negotiate with the employers, and everybody is forced to operate under a bunch of state mandates. My wife is biologically done having babies and I've had a vasectomy, but we can't get health insurance with no maternity benefit. Also I can't buy health insurance without benefits for naturpaths and acupunturists, even though I don't intend to ever use either of them.

  It's like being forced to buy auto coverage that includes a Lexus SUV, just in case I might want to buy one some day.
• 

  restrangled

  Elsewhere, Florida is also getting absolutely ridiculous.

  We just can't shut off the air in summer or the heat during the bad months. My bills range anywhere between 300.00 to 500.00 a month.

  Water just increased by 10 percent.

  Progress Energy is fighting to increase rates again....for what? That we have power outages/surges almost daily, after hurricanes they can't restore power for days, we have all above ground wiring, and they just installed digital readers in most homes.

  Yep.....I'm ready to pay more once again.

  Components of a residential electric bill per 1,000 kWh	Current	January 2010
  CUSTOMER CHARGE: A fixed monthly amount to cover the cost of providing service to the customer’s location. It is applicable whether or not electricity is used. This charge is a base rate charge and has not increased since 1992.	$8.03	$8.03
  ENERGY CHARGE: All the costs, other than fuel, involved in producing and distributing electricity including: base rates, nuclear cost recovery, capacity cost/purchased power, energy conservation and environmental compliance.	55.69	65.63
  FUEL CHARGE: The actual cost of coal, oil, uranium and natural gas used to make electricity. Progress Energy actively manages fuel expense and makes no profit from the fuel component of the bill.	56.00	46.11
  RATE ADJUSTMENT: T his PSC-approved base rate adjustment, which was part of the company’s 2010 base rate filing, went into effect in July and is subject to refund.	4.41	4.41
  Subtotal	124.13	124.08
  GROSS RECEIPTS TAX: Collected in accordance with the Florida statutes, this 2.5641 percent tax is assessed on all electric public utilities and paid directly to the state.	3.18	3.18
  TOTAL: Note: Franchise fees and municipal utility taxes may be in cities that have enacted ordinances for these fees and taxes .

  r.
• 

  littlerockguy

  What are you talking about SammieLee, hospitals already have "facility charges" and other fees that are padded on bills and sent to insurance companies. Medical groups milk patient's insurance companies for as much as they possibly can to offset the low charges of people who do not have insurance, Medicare and Medicaid

  For example:

  A mother who has insurance for her child goes in to get a vaccination that may be $100 (Menactra is over $100 but we will use $100 as an example) for the medicine alone plus the "administration fee" of $43.

  Another mother who has no insurance and is self pay the same shot would be $13.30 (actual child vaccination fee self pay with no insurance) and no administration fee.

  A mother who has Medicaid will only have to pay $10 and there is no "administration fee".

  These are pretty accurate prices right now. I should know I enter in all these transactions all day for 4 clinics but it gives you an idea how much insurance companies pay out for the insured compared to how much money the facilities get from Medicaid and self pay. And oh yeah, if you pay the whole bill when services are rendered they take off 20%. This is at a Catholic run healthcare facility - I cant speak for other facilities.

  LRG
• 

  moshe

  What about cable TV? I have to pay for the Golf channel, wrestling, NBA , NFL, etc and I never watch those programs.

  My cell phone plan comes with texting automatically , but I never use that, so I am subsidizing those who do.

  My telephone has 3-way calling, I'e never used that either.

  If we get healtcare from Congress, it will only last a few years, before we will rebel at the cost and force the govt to institute a non-profit system. They only need to look to other countries who have the most efficent public systems and copy that. It's not rocket science.
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  VoidEater

  Another one: ATM fees.

  It's diret cheap for a bank to service you through an ATM - no bank teller to pay. And indeed some banks now charge you if you use a teller!

  Thank you for letting me pay you extra just so I can pay you for the service I receive.

  Capitalism running rampant.