A Warning About 'Hospital Fees'

I'm not talking about going to a regular hospital or it's out-patient care unit on it's main campus. Here's what I am talking about.

My wife had a microcalcification show up on her annual mammography a few months back. She went to our local surgeon who extracted a sample for biopsy. This minor procedure was done in the doctor's office suite. Our insurance company's accepted charges were close to $400. In the end the costs to us was $78 after insurance paid the rest. Plus the doctor's charges of $138, which we paid $27.60 as our share. So the total costs to us was $105.60.

Since then her doctor has joined a hospital network. From what I gather his "office suite" would now be considered a "out-patient care facility". If she underwent the same procedure it is possible we could be on the hook for a hospital fee of about another $200.

I'm not sure how much of these new additional hospital fees my insurance company would cover, but I can tell you this. We never will know, because in the event we need his services again we will be asking his billing clerk questions and if there are new "hospital fees", forget it. We'll go somewhere else. I simply can't see my insurance company being billed $738 for the same procedure that only a few months ago cost $538. That's a 37% increase!

I certainly have no way of knowing, but I wonder. Did my doctor join this network in lieu of having to pay rent? If that's the case will the doctor lower his $138 charge since he no longer has that overhead? I THINK NOT!

Perhaps the doctor should just put a $200 turnstile outside the waiting room before entering just for the privilege using the facility. It's the same thing. Does it matter whether you pay before entering or getting a bill in the mail a few weeks later?

Patients need to make a statement. Perhaps if this doctor loses enough patients, others will think twice before going this route. Question is, how many people will take a stand?

That's exactly why I posted this information. So that people will make a statement.

Even though this isn't something brand new for a lot of people. It is for our doctor's practice. I want people to become aware if their own doctor switches over and encourage them to take action. Call your doctor. Check if they now have become an "outpatient hospital facility" that imposes this new additional fee. Let them know you no longer will be visiting them if there is. The same goes for the men and child patients as well.


An Article About This

When Hospital Fees Catch You Off Guard
Anna Wilde Mathews | Wall Street Journal

November 25, 2009: "... doctors' offices in clinics owned by hospitals, besides billing for the physician's work, might also tack on a "facility fee... Even for insured patients, such additional charges can drive up out-of-pocket costs... The issue is "the expansion of hospital services far from their campus, but still billed" as if they were offered in the hospital's main building."
Another thing you might not be aware of is...Even though a hospital or it's off campus network treating you may be "in-network", not all of the doctors treating you may be. If they are not, you will be charged at the higher "out-of-network" rate for the physician who provided treatment. * * *

“The bird hunting a locust is unaware of the hawk hunting him”
~Proverbs~