Facility Fee?

by fireyone » Tue Nov 25, 2008 12:56 am

Hope this arrives in the right section of the forum.(Health Insurance).
I just got a ton of bills in the mail from my area hospitol. I go to a pain clinic that is run by the hospitol but is actually outside on their grounds. Its a building off to the side. I have always paid the pain clinic up fron t all my deductibles so they did not accumulate. Sometimes ths hasn't been easy with so many appointment and co-pays but thus far I have done it. Well I started getting numerous bills in the mail asking for me to pay more co-pays. Thinking that this was some billing errors I called and was told that no it is in fact correct. Not only was I responsible for paying the pain clinic a $20 co-pay but I also had to pay the hospitol a $20 Facility Fee. I argued this upside down saying I could have easily went elsewhere had I been told this before. Why would I want to go there and pay double when I could go somewhere else and pay once? Is there anyting I can do about this especially since I was not told ahead of time and then they dropped this on me all at once?

Total Comments: 14

Posted: Tue Nov 25, 2008 12:58 am Post Subject:

OOPS...they want the $20 fee for every appointment I have had with the clinic. They are now just catching up on the billing?

Posted: Tue Nov 25, 2008 02:37 am Post Subject: insurance

FIREYONE...the Pain Clinic ISN'T 'related' to the hospital, in any way? Wow.......in my 'area' the Pain Clinic ( or something similiar..) is located right inside the hospital. Gosh.....making 2 payments doesn't make sense..ya know?

Posted: Tue Nov 25, 2008 03:07 am Post Subject:

Yes it is related to the hospitol...actually a part it..thats what I can not understand. I am debating it woth them as we speak and have called my health insurance on it. Gee a facility fee? Thars a crock of you know what. I am really aggravated.

Posted: Tue Nov 25, 2008 10:19 am Post Subject:

Yeah, it's pure bs but likely legal..see what your carrier has to say about this, then if they say nothing you can do, then I'd contact as high up the hospital chain as I could starting with the admin..(top dog)...the biggest problem I see is two fold..first the pain docs are paying a fee to the hospital to do buisness there, and second you were not made aware of this until how much is due?

Posted: Tue Nov 25, 2008 11:27 am Post Subject:

Well as my BS as it is I am hoping not to be responsible...I can only imagine the amount. When I called the hospitol yesterday concerning the bill they said I owed them the money. I informed them this is the first time I ever seen this charge and had always paid the $20 co-pay only to the clinic. She said that the billing was not put through properly and that I infact should have been paying them a co-pay the whole time also. I asked her if they could legally back charge me after the claims were already put through and she replied that she had to look into the matter and would call me back. Now I am wondering by making the call if I screwed myself but I couldn't figure out why they were sending me a bill. I turned it over to my insurer to look into and hope to ehar something this week.
If it is the way they can bill I got to figure out another way I can get treatment without going through them. I am not going to pay them double. I'll get it figured out one way or another I just hope they do not bring all the charges forward from the past...I couldn't count all the times I have been there. I hope the lady was bluffing but I'll see, hopefully soon.

Posted: Tue Nov 25, 2008 12:28 pm Post Subject:

I would tell them since they admit it was their mistake

I informed them this is the first time I ever seen this charge and had always paid the $20 co-pay only to the clinic. She said that the billing was not put through properly

That you were kept from making an informed choice about your care, and in fact it would appear to others (ie whomever it is that governs hospital) that this is some sort of 'bait and switch' meaning they led you to believe that you owed nothing more than you had been paying, then bam you owe this much...IMO that debt (the co-pay they can still collect from your carrier) should be forgiven or waived, but should start from your next appointment, now that you are aware of it, which there will likely be none because you will find another facility...ask your doc at the pain clinic about this as well...

Posted: Tue Nov 25, 2008 05:59 pm Post Subject: insurance

Well, FIREYONE,..I can't blame you for being mad. I'd be upset, too. If the Clinic is a part of the hospital, then why are you making double co-payments? Gosh...I'd be yelling in someones ear about that one!! :lol:

Posted: Tue Nov 25, 2008 08:24 pm Post Subject: Facility Fee

As a Benefits Administrator in the Kansas City area I have been dealing with this BS for about two years now. A new system just came into the area and are a preferred provider on our health plan. However, they are charging a facility fee. Supposedly, for the "privilege of using their facility". No joke, that is the exact words from their COO. I used the same premise of "bait and switch", along with some very taut language on referring employees elsewhere and eventually had the costs written off. If they would like your business in the future it would make good business for them to excuse the amount. I would also contact your Better Business Bureau and report it if they did not make you aware of the payment before billing. This is bad practice at best and downright criminal at worst. Push for your consumer rights!

Posted: Tue Nov 25, 2008 09:35 pm Post Subject:

Are they required to inform you of this fee before an appointment? I would think that this should be a policy because then I would have had a decision to either use them and pay the facility fee and docotr fee or I could have chose to go elsewhere(which I would have done) where I could have paid on fee. I am hoping this doesn't just slip through the cracks because I feel the person is being decieved when they do this.

Posted: Tue Nov 25, 2008 11:00 pm Post Subject: insurance

Yep.........FIREYONE, I would think they would have to let you know of the 'additonal cost'. If for some reason, you DON'T have the 'additional cost', after your apt is done and over with, what would they do?.....just not let you leave until it's paid ( sarcasm of course!!) Good grief!!

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