Drs office facility usage fee

[etraible]

The Cleveland Clinic started last spring billing patients a "facility usage fee." on top of your co-pay. I didn't know about it until I took my son to the doctor in June, I paid my co-pay as usual but then I got a bill for $38.50. The fee was originally $55, but my insurance negotiated it down (like they negotiate all services down from the original charge.) So now if we use any doctor at the Cleveland Clinic it costs my co-pay of $15/$25 (specialists are more) PLUS $38.50. I think this is too expensive and I will not be using them anymore. BUT - I also wonder if since a major institution started this if others will follow the practice. Anybody else have this happen to them?

 

[Blue.Fairy2]

OMG! did you have a party? or maybe a wedding reception?


GIVE ME A BREAK!!!!!


and the medical profession wonders why we need to get health care costs under control...

 

[Shelly F - Ohio]

Hi Neighbor - I am in Lorain County too. Did you call and ask what this fee was for? When you do let us know. Then I would call your insurance company and let them know about this fee. Dr's can only bill for services rendered.
Maybe you should send the dr a bill for your time spent waiting to see him.

The Cleveland Clinic started last spring billing patients a "facility usage fee." on top of your co-pay. I didn't know about it until I took my son to the doctor in June, I paid my co-pay as usual but then I got a bill for $38.50. The fee was originally $55, but my insurance negotiated it down (like they negotiate all services down from the original charge.) So now if we use any doctor at the Cleveland Clinic it costs my co-pay of $15/$25 (specialists are more) PLUS $38.50. I think this is too expensive and I will not be using them anymore. BUT - I also wonder if since a major institution started this if others will follow the practice. Anybody else have this happen to them?

 

[addicted2mickey]

Our local hospital has done the same thing. See a Doctor in their facility and they bill you for the Doctor renting space from them and the Doctor bills for the office visit. I had to call my insurance company and they called the Hospital. They are not permitted to bill 2 co-pays for the same visit. Check the fine print on your insurance. All it took was one call to the insurance and they forced the Hospital to waive the 2nd co-pay.

 

[etraible]

Hi ShellieF. Yup, I called. Actually the first person I called was my HR department. They said, "our insurance lawyers are talking to the Cleveland Clinic's lawyers, but in the meantime you are responsible for the charge." Then I called my insurance company, they too said it was a legitimate charge and that I was responsible for it. It would apply towards my deductible (I've only met THAT when I had a baby, which is good in a way since it means I'm pretty healthy.) Then I called the ombudsperson at the Clinic and voiced my feelings, they didn't seem to care. I called my doctor and cancelled my upcoming physical and told them why. He's stuck in the middle though - it isn't him that's charging it, its his employer. When I called to pay the bill I told the person I was unhappy about it - I told her I knew it wasn't her but that I wanted to let them know I wouldn't be back and why. She said they have a special code to enter in the computer for people who are upset by this.

At this point, even if they take away the fee I won't be back. This whole thing has just left a bad taste in my mouth.

I think when I went to my sons doctor appt and paid my co-pay, they should have at that point said, "oh, this is going to cost you $55 or so more."

 

[etraible]

Hi addicted to mickey. I wish I had this quote thing down - I don't know how to use it. I tried a couple times and it didn't work. I don't have a copy of my insurance contract - I just have a summary of benefits. I wonder if I went to the website if it would be there. Thanks for the idea, I'll definitely check on it.

 

[Piecey]

Not really the same thing, but I'm in a battle with my hospital over a "Facility usage fee" as well.

They charged one (over $300 a piece) for every stay I had in L&D. I had a lot of them- I needed to get my gallbladder out but they wouldn't operate until I delivered so I was told when I had an attack to go to L&D to monitor baby and such.

My insurance refuses to pay it because they say it is a "clinical charge"... the hospital waived one but I'm still waiting on the others. Such a mess.

 

[Pooh Crew]

Yes, I'm in Texas and had to pay a facility usage fee for my son's endocrinologist. He operated out of several places, so I just switched where I saw him.

 

[MIGrandma]

All these extra "fees" are just getting ridiculously out of hand.

DH was charged a "new patient fee" when he went for a physical after he turned 50.

Funny thing is, he'd been going to this physician's office for his entire life so he was NOT a "new patient", but because he hadn't been there in 3-4 years they added on this "fee." He balked about it but they wouldn't budge. Almost made me want to switch doctors so we really would be new patients then! It's just so frustrating. And their "office visits" just keep getting more expensive all the time.

 

[starwood]

We have an urgent care facility that has started charging (I think it's $30) if you go in on a Saturday or Sunday. Of course the insurance doesn't pay for that.

 

[minniem]

We have to pay a "facility use fee" or whatever it's called when I take my DD to see a specialist that is affiliated with the hospital. They even sent us a letter prior to the appt and said we would be charged once for the doctor and once for the facility.

We changed our health insurance when we moved and this new plan seems like it has a lot of "extra charges". It's crazy!

 

[TaraPA]

I'm absolutely dumbfounded. Surprised? Not really, but just speechless. Way too many doctors hospital have become businesses first, care givers second.

Last year DH had 3 hernias that needed to be removed/repaired ASAP. He was in a lot of pain that was affecting his normal routine. The hospital network we have used all our lives was just sending us in cirlces for testing, appointments with specialists, more testing, which in turn was weeks of co-pays, non-covered tests, deductibles not being met, etc. When they finally determine surgery was necessary, they couldn't get us in for 4 weeks. Of course they wanted to see him weekly for monitoring (yes a $25 co-pay each time of course, plus lab fees). We were also charged the physician's "facility usage fee" for seeing a specialist in a location other than his own - and we never even requested to be seen offsite.

Our neighbor is a urologist in a nearby state at a non-profit hospital network. He examined DH off the record (which legally he is not allowed to do due to malpractice insurance regularions, so we were very greatful) and said DH needed surgery immediately, he'd clear his schedule for 2 days later, and he'd let the hospital & surgeons know. Our insurance didn't particiapte with this hospital network & he told me not to worry, they are in the business of helping patients & saving lives first , not making the almighty dollar above everything else.

Let me just tell you our experience with that non-profit hospital organization was incredible. Everyone bent over backwards to get DH's pre-op done in 24 hours, and everyone assured us not to worry about paying. They accepted whatever our insurance would send them as payment in full. I saw the hospital bill on my insurance website - and since it was out-of-network my insurance barely paid half - and we have never been asked for a dime. All of his follow-ups weren't covered at all - and the surgeon insisted on not billing us. Our neighbor was the first to bill our insurance and all of his charges went towards our deductible - he refuses to take a dime. We have since switched over to that hospital network, even though they are out of state & out of network. The level of quality care we have received there is far greater than anything we've ever received. I don't know how these non-profit organizations stay in business with the high cost of healthcare, but they will get my donations first from now on. It truly opened my eyes to see how our local hospital is running themselves as a money-making business first & foremost. I'm not saying all organizations are like this, it was just our experience. It's sad.

 

[Forevryoung]

Don't blame the doctors or the facilities that are trying to cover their overhead. Blame the insurance companies. They are the ones (including and especially medicare/medicaid) that are keeping the money.

How is a facility or a doctor supposed to pay their general overhead and still make a dime when for-profit insurance companies are holding the money over their heads. Since when is it acceptable in any other field for someone to say my fee for that service is xxx and the other individual says "uhhhh I'll just pay yy"????

So people have had to figure out how to charge to cover just a little bit more of what they won't be paid to make ends meet.

My favorite insurance story involves my mom calling an insurance company because of a denial she got (she's a provider not a patient). She billed them a few hundred dollars and they sent her a check for three dollars. One notice requested that she return a patient's co-pay because even that was "too much paid" for an hour long visit.

Hmmmm anyone else work for FREE???

 

[minniecarousel]

What an eye-opener!

I had no idea that "facility usage fees" are being charged now. I haven't been aware of these in California, but we'll keep an eye open for this practice.

 

[SharpMomOfTwo]

So by usage fee, I assume they mean the office. Ok, let them know next time you want to have the examination out in the parking lot!!! That is the stupidest thing I've ever hear of!! People will do anything and everything to make an extra buck. The nerve!!!!!!

 

[delilah]

You know, I am going to talk frankly to you all as a physician. I am seriously thinking of quitting the part of my practice that involves visiting patients in Nursing homes. The reason is simply this. I am employed by the hospital to which I admit patients. I am paid a salary, like alot of the rest of you are. When I visit a patient at a nursing home, I net something like $10/visit, after all contractural allowances and discounts are taken, which goes to the hospital, which in turn pays my salary. But, it costs me $10 for the round trip from my home to the hospital or nursing home. Plus, I have to pay for child care for my son. I try to consolidate trips--nursing home is across the street from the hospital. But, I already work normally about 12 hrs per work day just with hospital and outpatient, and I have to pick up my son at aftercare at school by 6 pm. I don't get paid extra for overtime to visit people at the nursing home, so I do it on my day off. But, I have to clean my house, do my laundry, mow my lawn, etc, on my day off. I don't get paid any more if I use my day off to see patients at the nursing home. I used to pay somebody to clean my house--it was about $150/wk. It would probably cost about the same to hire somebody to mow the lawn and do the landscaping that I do for "free". I still have very little "recreation" time, unless you consider cleaning house, doing laundry, pulling weeds or mowing the lawn "recreation".

When I was self employed, the hospital charged each of the doctors in my office about $1800/mo for rent. We have 6 doctors. $1800 is more than my mortgage, and some months, I was barely able to pay my mortgage. So, now I am employed, and the hospital gets the proceeds from my patient visits, and I get money to live on. Apparently, Cleveland Clinic is trying to recoop the rent they used to get from physicians in private practice. I don't think that the doctors are getting any more or any less from this charge. So any venom directed toward doctors because of the greed of the insurance companies and health care administrators is misdirected.

 

[Cheshire Figment]

I have a tax client who is a physician (podiatrist) and his only office is in a hospital. He pays rent to the hospital which includes his office space, HVAC, electricity and water, and parking for staff and patients. He does pay separately for cleaning of his office. But this is part of the costs of his doing business.

 

[Pixie Dust for Me!]

Hmmmm...I think if my doc tried this, I'd charge him a "chair warming fee" for the time I spend waiting for him!

Completely and utterly ridiculous!

 

[clarabelle]

Our local teaching hospital does this if you are a private patient and you see one of the attendings as opposed to a resident. It is in the "for profit" part of the hospital -not the teaching part.
Anyway -they charge the facility usage fee -but their doctors fees are less -so it may not be anymore money that what you would pay your private doctor.

 

[DawnCt1]

I asked DH about this. He said that the physicians at the Cleveland Clinic are all salaried and do not own the practices and do not benefit from the income that they generate. So, in essence, they don't have a practice or an office that they pay rent or overhead for. It is a space provided for them, along with a salary.