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[Music]
DAN: With all the changes in health care
you might be seeing your doctor in a new location
and with that might come a hidden fee.
It's called a facility fee and today I'm here with
Shara McClure, who's our Senior Vice President
for Health Care Delivery at Blue Cross.
So, Shara what's a facility fee?
SHARA: So, a facility fee is a price that
a hospital charges to access services.
So if you separate the way a hospital bills,
from the way a physician bills,
physician bills for the services that are provided
in their offices, but if that physician is affiliated with
a facility you could see a bill for both services.
DAN: But I'm not going in the hospital, right?
I'm just seeing my doctor I've seen my doctor
the same doctor for a long time and now
I'm asked or I get my bill and I have a $600
facility fee. Why did that happen?
SHARA: It happened because that physician is affiliated
with the hospital and that hospital feels like they're
providing outpatient services but in reality
it's just as you describe.
That physician, one day can be independent
and not have a facility fee and then all of a sudden
they're acquired by a hospital and boom
you get the facility fee as well as the physician.
DAN: So, I think we need to be pretty clear here,
so my doctor is probably not getting that facility fee,
it's not necessarily going to my doctor right?
It's just something that's getting added because he
now works for a hospital system?
SHARA: I think so, now I'm not privy to what the
doctor gets but again it just immediately changes and I
guess that office all of a sudden becomes like an
outpatient facility of a hospital and…
DAN: So it's almost like I was going to the emergency
room when I get charged that facility fee?
SHARA: It kind of is because, you're right you go into the
emergency room you get treated by a physician you
use the hospital services maybe their observation room,
or their exam room, or their MRI, or their lab but you
get charge for both the hospital bills and the
physician bills and I guess you can think
of this as a smaller scale.
DAN: So, I think every consumer in America right
now is used to the added fee it seems like every time
I open my utility bill I've got a new surcharge
new fee, new tax so that in and of itself is not
shocking but what shocked me about the facility fee was
this is not a little fee. This was like $600!
SHARA: It can exceed the services that just the
physician provides, or just the services that the
physician would have provided had they not
been part of a hospital system.
DAN: Okay so I'm just gonna be frank with you.
This seems wasteful to me because the same service
that I was getting with my physician before
I'm getting the same service now and now I just have a
cost added to it?
SHARA: We hear about that a lot from patients.
We hear about it from employers, how it feels like
just overnight the price has escalated without the
corresponding increase in service or increase
in quality.
DAN: So Shara what can I do… what can a
consumer, member do if they get an
explanation of benefits and it's got a facility fee?
Can they contest that or do anything about that?
SHARA: I think that they should let their physician
know that they're not pleased with it.
They can make a complaint to the facility that's charging
the service and as an alternative they can look
for other physicians that practice independently and
don't charge a facility fee.
DAN: Great.
Well, thanks for shedding a little light on
the facility fee and thanks for joining us for this
episode of Blue Promise.
[Music]
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