Kathy Young, the veteran benefits administrator for a large plumbing supply company headquartered in Madison, Wis., is well versed in the often fiendish complexities of medical bills.
But when Young, 54, received a $25.59 bill for a "facility fee" separate from the $207 physician's charge for a recent routine eye exam, she called her health plan for an explanation. Young was told the fee was a "room charge" -- an item she might not have noticed previously.
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It is the result of an obscure change in Medicare rules that occurred nearly a decade ago. Called "provider-based billing," it allows hospitals that own physician practices and outpatient clinics that meet certain federal requirements to bill separately for the facility as well as for physician services.
Because hospitals that bill Medicare beneficiaries this way must do so for all other patients, facility fees affect patients of all ages. Doctors' offices owned by physicians and freestanding clinics are not permitted to charge them.
Examples:
The first case was filed after plaintiff Lori Mill was charged $1,133 for a 30-second toenail clipping to check for a possible fungal infection performed by a doctor at a clinic attached to the Virginia Mason Medical Center. Mill said she visited the clinic because it was near her office and was never told about the $418 facility fee until she got the bill. Her plan required her to pay 20 percent of her medical bills. The same procedure at a different Virginia Mason facility, which was not designated an outpatient clinic, would have cost Mill a maximum of $269 -- and no fee.
A second patient, DeLois Gibson, was charged a facility fee of $846 for removal of a bump on her neck; the total bill came to $1,451.
A second lawsuit was filed against the University of Washington Medical Center on behalf of Heidi Rothmeyer, who was charged $8,189 for an office procedure involving the removal of cysts; of that amount, $6,839 was the facility fee.
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/05/AR2009100502910.htmlSoon there will be a meter in the room that measures how much air you use. Then you will be charged an "evironment replenishment" fee for the amount.
MEH!
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