When 27-year-old Brianna Snitchler scheduled an appointment to remove a cyst, her physician recommended a simple biopsy to check the growth for cancer first. Brianna’s biopsy was performed via a guided needle at a local hospital. It took 20-minutes using a local anesthetic, and she didn’t even have to change into a gown.
After the test results came back benign, Brianna was ready to schedule the procedure to have her cyst officially removed. That is until she received a surprise bill for $3,357.52.
This unfortunate story published by Kaiser Health News has many American patients shaking their fists in rage. Similar to countless others before her, Brianna fell victim to a facility fee, otherwise known as a cost to ‘rent the room’ she was treated in. Of the $3,357.52 bill Brianna received, a shocking $2,170 consisted of a facility fee for using the radiology room in the hospital; none of the fees was covered by her health insurance.
These types of situations highlight an urgent need for transparency in our health care system. Medical bills with unexpected charges, such as facility fees, can sink individuals and families quickly into debt. In turn, patients are neglecting their health and turning away from needed services based on financial fear.
Until change arrives, Connecticut patients must do their due diligence to know when these fees may apply and how to reduce costs safely.
When Will You See Facility Fees on Your Medical Bill?
Facility fees are unique to the United States health care facilities. Facility fees are similar to a rental fee for time spent in a treatment room and for the costs associated with the procedures the patient needs. These fees are on top of a doctor’s fee or a fee for performing a medical service.
The ‘facility’ where these fees can be applied will differ. Some areas where they may apply include tests, scans, or medical procedures performed in the following facilities:
- Hospitals
- Outpatient Medical Centers (if owned by a hospital)
- Physicians Offices (if the doctor is employed by a hospital)
According to The Alliance, facility fees can range from $15 to thousands of dollars in extra costs for patients depending on the services provided. Facility fees are most commonly applied in hospital settings. However, as more hospitals take ownership of medical clinics, outpatient surgical centers, and even physician’s offices, facility fees are starting to become more frequent across the board.
Why Facility Fees Make Medical Bills So High
So what does a facility fee actually cover? Some of the costs include:
- Staff salaries: The number of medical personal and types of physicians involved in your procedures could affect the cost of the facility fee. For instance, specialists make significantly higher salaries than primary care physicians.
- Overhead costs of the hospital: This portion of the facility fee includes costs that keep medical facilities running, but do not directly affect the health of the patient. Supplies, billing, and laundry services are all examples of overhead costs that could increase the bill.
- Radiology or specialty medical equipment: In the cyst biopsy mentioned above, Brianna’s facility fee consisted of charges for the radiology equipment used. Specialty equipment can include patient monitors, sterilizers, anesthesia machines, MRI’s, and more.
What Makes Facility Fees So Tricky
There are several reasons why patients are receiving surprise facility fees:
- Lack of Transparency: The most deceiving part of facility fees is that service providers, such as hospitals, are not obligated to disclose them. Legally, there is no law requiring them to warn patients up-front that there is a hefty facility fee coming their way if they go through with a procedure with them.
- Medical Inexperience: If a patient does ask about the cost of a facility fee regarding a certain procedure, service providers will typically give an estimate or even exact number depending on your case. However, some patients who have not required any medical procedures or tests in the past may not know to ask.
- Booking By Time: Scheduling an appointment by time rather than location puts patients at risk of higher facility fees. A test performed at a hospital as opposed to at a medical center will have a much higher facility fee for the same services.
- Hospitals Are Expanding: Another factor that has started to impact patients who have done their best to avoid facility fees is that hospitals are more frequently claiming ownership over smaller service providers. A hospital-owned surgical center or physician’s office does not have to inform patients when a facility fee is applicable, and they can charge a higher fee for hospital-grade services.
- Patients Are Scared: Patients who are fully aware of facility fees and when they apply are scared to have services performed at non-hospital service providers in fear that they are lower in quality. They are paying more for the same services, sometimes with the same doctors, that they could undergo at a doctor’s office or outpatient center.
How To Prevent High Medical Bills
Patients do not have to fall victim to outrageous facility fees. According to Clear Health Costs, there are multiple ways you can protect yourself financially:
- Always ask about prices and facility fees upfront.
- Compare times, as well as locations, when booking appointments.
- Do not assume a physician’s office or medical center does not have a facility fee.
- Ask outpatient facilities if they are affiliated with a hospital that affects their fee rates.
- Know your insurance policy coverage when it comes to facility fees.
- Talk to your doctors about your procedures and discuss where it is safe to have it performed (hospital or outpatient).
The bottom line is do your research, or have someone assist you in asking these questions, before undergoing any medical procedures. Choosing a lower cost facility with outpatient services may not always be in your best interest depending on your health. Talk to your doctor, your insurance company, and the facilities that provide your treatment to make an educated decision on your care.
Connecticut Personal Injury and Medical Malpractice Attorneys
At the law firm of Jacobs & Wallace, we believe your family’s health and safety should be a priority. If you or a loved has been injured in an accident due to a preventable medical error, you may be eligible to receive compensation for any damages suffered. Contact our expert team of personal injury and medical malpractice attorneys at Jacobs & Wallace for a free consultation to explore your options.
