The Seattle Times article, “Why You Might Pay Twice for One Visit to the Doctor,” reveals a disturbing and clearly abusive trend happening in doctors’ offices nationwide.
The Medicare Payment Advisory Commission discovered that some hospitals have been tacking on facility fees for routine doctors’ visits just because they are located in a hospital setting or office building. Justification is apparently under the ruse of hospitals having higher overhead and needing to pass it on to the associated medical practices who just happen to share the real-estate.
The only way to combat this practice is for patients to refuse to go to such doctors and for insurance to refuse to pay these fees when charged.
Notification of the practice in unambiguous terms is a good start but this should take place before the actual visit. The patient should understand that their carrier will not pay this charge and that it may be their out-of-pocket responsibility if they choose to visit such facilities. Read More…
The Facility Fee:
This 2011 example of Medicare rates shows different payments for a mid-level routine visit to a physician’s office and to a clinic or office licensed as a hospital outpatient department.
Service in physician’s office:
• Payment to physician: $68.97
• TOTAL: $68.97
Service in outpatient department:
• Payment to physician: $49.27
• Payment to hospital: $75.13
Source: Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy, March 2012.