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  • Hatton1 is mad

    I am really mad about something and I would like to get some input from this forum before I start firing off angry emails to the CEO of my hospital.  I recently went to see my internal medicine doc about some joint pain and increasing Raynaud's Syndrome in my hands.  I am generally very healthy so I rarely have blood drawn.  He ordered some blood testing which was done in a lab draw station in a medical office building not in the hospital itself but on campus.  The only procedure performed was a venipuncture.  I received a bill from the hospital for $250.  I called my BCBS carrier and was told the hospital is charging a "facility fee".  She stated they can do this if they want to.  I told her this was not a procedure or a complex test but a simple blood draw.  This charge does not go toward the deductible.  I have my office manager contact the hospital billing office but they subcontract the billing out.  We have contacted the billing company and formally disputed the charge.  I got a robo-collection call yesterday while seeing patients.  Am I crazy or is a $250 charge for a blood draw over the top! (BCBS paid the lab charges at their negotiated rate FWIW.)

  • #2
    we have had this in place a long time.  you show up for anything--you get facility fee.

    nothing you can do about it in my experience.

    this is part of the way the hospitals bill after acquiring formerly private practices.

    it is now standard and customary.   i can't believe you only got hit now--unless you have been in an environment where hospitals weren't employing most of the physicians until recently.

    i get killed on press ganney.  patients think it is coming to me.    hospital just wants to know why i'm not getting 5 stars from the patients.  i point to the comments--facility fee, room not clean, waited too long at check in.   how are those attributed to me?

     

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    • #3
      Qschool my internist is not a hospital employed physician.  It was just an office visit with a blood draw.

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      • #4
        it's the hospital doing it, not the physician

        does the hospital have employed physicians?  even if your internist is not one?

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        • #5
          Yes the hospital has some employed physicians.  This draw station is in a building where I do not think many of the docs are employed.  I also had some blood drawn in a Rheumatologist office the following week which was sent to labcorp.  No charge.

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          • #6
            The physician could have sent you elsewhere with no facility fee, right? Maybe he/she doesn't know?

            That's [expletive]ing ridiculous, $250 just like that, with no recourse. I don't believe it.

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            • #7
              I could of had the blood drawn in my office for $0 dollars had I known this.  The charitable explanation is it is miscoded but I think people just do not pay attention or understand their bills is likely allowing this to happen.

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              • #8
                I am going to discuss this with my internist as well.  I think he might not know about it.

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                • #9
                  I am sorry for that experience. I get < $5 for any blood draw performed by my MA.

                  The facility fee permeates many hospitals, clinics and hosp employed offices and facilities. The internal med doc is most likely as surprised by this as you are. Really no one to blame but the hospital.

                  Educate the internal med doc of the scam, write it off as a lesson learned and from now onwards only go to a blood draw facility set up by Quest / Lab Corp etc that is in your insurance network.

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                  • #10
                    Yes, let your doc know. I'd be super pissed to find out that patients would get this charge at some of the labs within the hospital system but not others (unless I'm misreading your post). Anyway, the lack of transparency in medicine is a huge issue. I'm so sorry you're running in to this.

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                    • #11
                      Yeah Kamban I have a blood drawer in my office which would of been convenient and free.  I think a facility fee is ok for some type of procedure but not a blood draw.  I think scam describes it well.  There was no sign saying this was possible. If you start trying to dispute something the insurance says it is the hospital and I am sure the hospital will blame the insurance.

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                      • #12
                        This is new norm -- $250 is crazy; our university labs charges $25

                        Still too high compared to what Labcorp/Quest is free AND charges less than the University.  But, it's convenient and integrates with our EMR so all stakeholders see the results quickly and efficiently.

                        ANY facility is allowed to tack on the facility fee, they can also do hospital based billing as an upcharge even though our facility isn't even on campus.  The High risk GYN next door does this, but not us (for now).

                        I can see in the future that we change over to hospital based charges as we are staring into a huge financial hole this fiscal year since Medical is paying so little and everyone is dumping them and simply enjoying their ERs being paid and still ultimately not getting preventative care.

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                        • #13




                          Yeah Kamban I have a blood drawer in my office which would of been convenient and free.  I think a facility fee is ok for some type of procedure but not a blood draw.  I think scam describes it well.  There was no sign saying this was possible. If you start trying to dispute something the insurance says it is the hospital and I am sure the hospital will blame the insurance.
                          Click to expand...


                          The hospital cannot blame it on the insurance, but it is unlikely they will waive it. They almost never do.

                          One thing I have found out over the years is that insurance rarely cares about money paid to hospitals or labs if it is not included in the copays or deductibles, or included in them but you have not met it. Only after you have reached the out of pocket and met them do they really bring the hammer down on the fees and the amount paid to hospitals and labs.

                          The lab we send to has an agreement with us to charge the facility a really low rate for labs sent via the facility. We use that to help indigent patients who cannot pay out high fees charged by the lab for uninsured patients.

                          For example the CMP is billed at something like $120 for uninsured, many commercials pay between $25-75 to the lab for it and then turn around and put that amount in the patient's out of pocket expense. The actual test cost billed to us is $4.

                          So even if our insurance covers it, I have blood draws for me and my family sent to the lab via the facility option and pay the lab directly by check. No bills from either the lab or my insurance for any lab. That freedom of not getting a bill alone is worth the small amount paid directly by me.

                          See if you have that option since you are self employed.

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                          • #14




                            Yes, let your doc know. I’d be super pissed to find out that patients would get this charge at some of the labs within the hospital system but not others (unless I’m misreading your post). Anyway, the lack of transparency in medicine is a huge issue. I’m so sorry you’re running in to this.
                            Click to expand...


                            I am worried about patients being charged this as well.  Hopefully as more patients have HDHP they will pay attention to their bills and start complaining about crazy charges like this. I put this post up to try to gauge if other docs in various specialities thought this was a crazy charge. It is looking like angry CEO letter to follow.

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                            • #15




                              This is new norm — $250 is crazy; our university labs charges $25

                              Still too high compared to what Labcorp/Quest is free AND charges less than the University.  But, it’s convenient and integrates with our EMR so all stakeholders see the results quickly and efficiently.

                              ANY facility is allowed to tack on the facility fee, they can also do hospital based billing as an upcharge even though our facility isn’t even on campus.  The High risk GYN next door does this, but not us (for now).

                              I can see in the future that we change over to hospital based charges as we are staring into a huge financial hole this fiscal year since Medical is paying so little and everyone is dumping them and simply enjoying their ERs being paid and still ultimately not getting preventative care.
                              Click to expand...


                              StarTrekDoc  I would not of posted this thread had the charge been $25.  $250 is the ridiculous, angry, this can't be right kind of level.

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