By Medical Bill & Claim Resolution (MBCR) | Submitted On January 29, 2013
There is an issue that has had a lot of coverage and continues to surface as a major source of frustration and distress for patients and others involved in the medical billing industry. The problem is this: as many hospitals and larger medical health networks are acquiring independent physician practices and clinics, patients are often finding that after the acquisition, they end up paying double or more for the very same doctor visits.
This issue deserves a lot of attention as you weed out some of the major issues and mistakes that can end up costing you hundreds more dollars for medical care.
Where Do Facility Fees Come From? The origin of the facility fee system is that government entitlement programs and insurance companies began to consider these extra costs justified for offices that were part of greater medical networks - the reasoning is that hospitals and medical networks need more money, in order to maintain their larger business operations. However, when a medical business simply takes over a doctor's office and charges double, patients, consumer advocates and even insurance companies argue that no extra value is provided and no extra cost should be assessed, especially for patients who have to pay all of this money out of pocket and can't afford the extra charges.
Place of Service Can Mean a Different Policy Not all facilities charge facility fees for a doctor visit. Some hospitals and networks don't charge facilities fees at all for visits to a particular office, and some only charge the facility fee when there is a procedure involved, rather than just a doctor consultation. But some of the hospitals and medical networks charging the highest facility fees for non-procedure visits are finding themselves on the receiving end of some legal challenges from consumers.
Consumer Responses Many of those who understand the practice of billing facility fees are arguing that these sorts of expenses wouldn't be justified in any other industry. In many ways, it simply doesn't make sense to charge patients extra simply because of a change in management or an acquisition. Patients are initiating class-action lawsuits against some hospitals, and in some cases, winning. Become proactive in managing future medical bill costs. When you learn that your doctor has merged with a large healthcare network, ask what additional fees may be charged and what services will prompt a facility fee. Or, if this is the first time you will receive treatment from this provider, request a run down of who will be billing you before receiving services. Small steps like these can prepare you mentally and financially.
MBCR understands the challenges in receiving a medical bill and successfully resolving a health insurance claim issue. Learn more at www.medicalbillandclaimresolution.com.