Sunday, April 14, 2013

Facilities Fees: A Surprising New Charge

Patients visiting some doctors' offices and urgent-care clinics are running into some unexpected charges. Added to their bills is a new item called a facility fee.

Facility fees are sometimes generated when a patient visits a hospital or a hospital owned building for medical services. The fees, which can amount to hundreds of dollars, are add-ons by hospitals to the fees charged by the physician, urgent-care center and other health care provider.

If a facility fee were charged in a non-medical setting it would go something like this. You have an appointment with your accountant at his downtown office. A week later you get a bill for his fees. Two weeks later you get a bill from XYZ Office Tower for $50 because you met with your accountant in XYZ Office Tower.
The good news for Anthem Advantage Plans is that they do not have to pay facility fees. Those insured by an Anthem Advantage Plan can ignore any facility fees and these charges should be removed. If the fees appear on a second bill, they should contact Anthem and Anthem will contact the provider to have this taken care of. 

Anytime you get hit by an unexpected fee, you should call your insurance agent first.
You can also check with your healthcare provider to make sure you understand the charge and confirm that it is allowed by your health plan. If you feel the out-of-pocket amount you're being billed is unfair, you can appeal the provider's bill or your insurer's decision. But if the health plan's contract with the provider allows for facility charges, you will likely run into stiff resistance.

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