Patients face ‘facility fee' after co-pay, even for video vi

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Patients face ‘facility fee' after co-pay, even for video visits

Some Bay Area patients are finding they’re on the hook for something they’ve never seen before: a big “facility fee.” And you could be too — even if you never actually step into a medical facility.

“I think it’s a very shady business practice,” said North Bay patient Wendy Ko. Her ordinary doctor visit took an extraordinary turn: to collections. She says she scheduled a routine visit at a John Huir Health office in Walnut Creek. She paid her co-pay, signed forms, and met with her doctor for 15 minutes. But later, John Muir Health sent Ko a surprise bill for $125, for a “facility fee” on top of her co-pay.

“I was confused,” she said, “I didn’t understand why they were charging me just to simply walk into the facility.”

John Muir Health told us its facility fees cover a wide variety of “expenses such as… nurses, technicians, environmental services, interpreters, security personnel… [plus] equipment, utilities and maintenance.”

Ko says she was unaware of her $125 facility fee. There was no price of admission posted anywhere and no verbal warning at check in. But John Muir Health said Ko signed a form agreeing to doctor fees plus ‘hospital facility services.’

Ko said, “There’s nothing about the amount. You’re basically just signing your life away. They could charge anything.”

She refused to pay. John Muir moved to start collections.

Ko’s not alone facing a surprise “facility fee.” Viewers around the U.S. are complaining to our NBC and Telemundo sister stations in places like New York, Philadelphia, Boston, Dallas, Miami, and Chicago.

“This is just totally wrong,” said Valerie Timpone, in Illinois. Timpone said she did a video visit with a hematologist and paid her co-pay. Timpone says Advocate Health Care later charged her a $60 facility fee for use of a “specialty room.”

We asked Timpone how many times before she logged in for her video visit had Advocate told her she was later going to be on the hook for a facility fee. “Absolutely none,” Timpone said. “No up-front disclosure. And it was quite upsetting. I could not believe the surprise bill after the fact.”

We contacted Advocate Health Care and asked how it justifies a facility fee for a video visit.

It did not respond.

Congress said it outlawed surprise medical bills in 2022. But the “No Surprises Act” was designed to prevent unexpected out-of-network charges, and does not address facility fees.

The American Hospital Association opposes federal reform, saying facility fees “are increasingly used to cover the true cost” of health care. Some states have taken action, according to the group United States of Care. A handful of states are outlawing “facility fees” or requiring new disclosure. California has not.

To help you avoid the jolt people like Timpone and Ko are getting, we turned to patient advocate Lisa Berry Blackstock. She’s a professional medical bill fighter.

“There are so many people coming to me, needing help,” she said.

Blackstock says the way you set your medical appointments must change, today. Before you walk into any doctor’s office or join any video visit, ask about facility fees. Then negotiate. Either haggle yourself or make your health insurer step in. And always demand an itemized estimate of your bill.

“You need these things in writing,” Blackstock said. “And that includes the facility fee.”

It turns out Ko’s paperwork states John Muir Health will give you an estimate, but only “upon your request.” Ko says a billing rep refused to reverse her $125 facility fee. She told them she was refusing to pay — on principle — even if it meant collections.

“That’s when I emailed NBC, and said, ‘this is what I’m going to do.’ And I didn’t have a response from them,” Ko Said.

We contacted John Muir Health and Ko’s health insurance company, United Healthcare. After we started asking questions, United Healthcare told us Ko’s “in-office visit has been reprocessed and will be paid in full… we apologize for this error.” We asked what the “error” was, but did not get a response. Ko is off the hook for the $125 fee, but still frustrated. And motivated to warn you.

“It’s just so shady that they have done this to people” she said.

Because John Muir did ultimately send Ko’s account to collections, we circled back with them. John Muir said it waved off its debt collector. Ko’s credit report should be clear, too. John Muir said it does not send delinquent account info to the credit bureaus — in line with California regulations.

[牛河梁]

这是啥保险？

[cng]

这是啥保险？

UnitedHealthcare was mentioned in that article. But it looks that the hospitals are increasingly trying to collect more than what insurances are allowed.

[牛河梁]

UnitedHealthcare was mentioned in that article. But it looks that the hospitals are increasingly trying to collect more than what insurances are allowed.

不如白卡