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  • #16


    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.
    Click to expand...


    Yes, I think it's crazy. I also think you should threaten to resign if something isn't done about the charge, both for you and for other patients who might have a tough time affording a $250 facility fee for a blood draw.

    You just might get the early retirement you deserve. Either that or some meaningful change in shady practices by your hospital.

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    • #17
      It could very well be an entry error of extra zero (at least my hopes are such!).

      You're right, this is how our clinic found out as a large group of patients were moved to a HDHP in our community and after then turn of the year, complaints started rolling in about the charge.  We adjusted by placing warning signs about the fee in the lab and that largely resolved the complaints that hit our plates.

      It's like luggage bag fees people got used to it as the new norm unfortunately.

       

       

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      • #18







        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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        Kamban I think this is how the uninsured really get hosed.  The lab work I had done was billed out at $2400.  The only unusual item was an ANA.  BlueCross paid $90.  An uninsured person may think what a deal if I negotiate it to $1200.  The lab I use in my office will bill my insurance and write off the rest.  Just a stupid mistake on my part to of had blood drawn and sent to the hospital.  Interestingly the rheumatologist repeated the labs through labcorp because she does not like the hospital labs methodology.

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        • #19





          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. 
          Click to expand…


          Yes, I think it’s crazy. I also think you should threaten to resign if something isn’t done about the charge, both for you and for other patients who might have a tough time affording a $250 facility fee for a blood draw.

          You just might get the early retirement you deserve. Either that or some meaningful change in shady practices by your hospital.
          Click to expand...


          I don't think threatening to resign would get any response at this point in my career.  I was thinking of an angry letter mentioning that I was going to post a copy on Facebook, WCI, POF, bogleheads, KevinMD, Financial Samurai, and ChiefMomOfficer identifying the hospital by name.  That is a lot of eyeballs.

          Comment


          • #20
            I have one just as good.  I am a hospital employee and work in a medical office building connected to the hospital via a walkway.  To make more money off our patients our hospital registers them to my office and to the hospital at check in.  That way if I order an x-ray they can charge hospital prices for the xrays.  They won't tell me exact costs but by kid broke his arm and even though he was in global for the reduction I got charged $570 for the xray and had to pay $273 after insurance for each xrays.  I meet with the CEO and COO and complained.  I even got all the other guys in my practice to come to the meeting because the way they have it set up is causing problems in the office and making it harder to see patients efficiently.  We were told that we make too much money to change it and it's not going to happen.  I order a lot less xrays now but it still makes me mad what we are doing to these patients.

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            • #21
              I have my own similar story. My teen daughter had a mole from her neck removed for functional and cosmetic purposes by a dermatologist at our hospital in her office. Unbeknownst to me, the specimen (which looked benign, and I would have chucked in the trash) was sent not to our hospital's pathologist but to the university pathologist 15 miles away. Of course, the university pathologist was out-of-network, and we received a bill for $250 or so to confirm that the mole that she had virtually since birth was benign.

              I think this is a major problem for the medical-industrial complex. Charges and bills are poorly communicated in advance, and surprise after-the-fact bills are far too common. Even if we are not participants in surprise bills, it makes us look bad.

              The lay press is full of stories of patients who did everything humanly possible to verify that all participants in their care (hospital, surgeon, anesthesia, radiology, pathology, lab, parking lot attendant, etc.) were in network prior to having a procedure, only to learn afterwards that there was an out-of-network assistant surgeon involved that charged tens of thousands of dollars.

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              • #22


                I don’t think threatening to resign would get any response at this point in my career. I was thinking of an angry letter mentioning that I was going to post a copy on Facebook, WCI, POF, bogleheads, KevinMD, Financial Samurai, and ChiefMomOfficer identifying the hospital by name. That is a lot of eyeballs.
                Click to expand...


                My advice is to write a calm but composed letter stating that tacking to a facility fee of $250 to a simple blood draw is an extraordinary amount. If they could lower the fee that would be helpful. Just leave it at that.

                No point in threatening to post to social media or to resign. They would not care and you would have burnt bridges for a $250 fee, that they will not refund.

                Save the bigger guns for a major fight in the future. This one is not worth escalating too much beyond a simple calm letter stating the facts.

                Of course, you are also free to disregard what I stated.

                Comment


                • #23
                  The way services are priced in medicine is insane, and every time I drift through the system as a patient it makes me a bit angry. I don't know how people with a lot of medical problems manage (unless they are on Medicaid or insanely rich).

                  Comment


                  • #24




                    I have my own similar story. My teen daughter had a mole from her neck removed for functional and cosmetic purposes by a dermatologist at our hospital in her office. Unbeknownst to me, the specimen (which looked benign, and I would have chucked in the trash) was sent not to our hospital’s pathologist but to the university pathologist 15 miles away. Of course, the university pathologist was out-of-network, and we received a bill for $250 or so to confirm that the mole that she had virtually since birth was benign.

                    I think this is a major problem for the medical-industrial complex. Charges and bills are poorly communicated in advance, and surprise after-the-fact bills are far too common. Even if we are not participants in surprise bills, it makes us look bad.

                    The lay press is full of stories of patients who did everything humanly possible to verify that all participants in their care (hospital, surgeon, anesthesia, radiology, pathology, lab, parking lot attendant, etc.) were in network prior to having a procedure, only to learn afterwards that there was an out-of-network assistant surgeon involved that charged tens of thousands of dollars.
                    Click to expand...


                    Vagabond is hitting on the problem.  These types of charges make us all look bad.  Nothing is transparent.  Alan I applaud you meeting with the administration.  You have the disadvantage of being an employee.  I am offended that the hospital is doing this.  I can afford $250 dollars but a lot of patients cannot.

                    Comment


                    • #25








                      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. 
                      Click to expand…


                      Yes, I think it’s crazy. I also think you should threaten to resign if something isn’t done about the charge, both for you and for other patients who might have a tough time affording a $250 facility fee for a blood draw.

                      You just might get the early retirement you deserve. Either that or some meaningful change in shady practices by your hospital.
                      Click to expand…


                      I don’t think threatening to resign would get any response at this point in my career.  I was thinking of an angry letter mentioning that I was going to post a copy on Facebook, WCI, POF, bogleheads, KevinMD, Financial Samurai, and ChiefMomOfficer identifying the hospital by name.  That is a lot of eyeballs.
                      Click to expand...


                      Make it the next PMG crusade.

                      Comment


                      • #26
                        Actually I do belong to that group DMFA.

                        Comment


                        • #27
                          Threatening to resign is a terrible suggestion imo. Especially for a trend that started ten plus years ago and is standard practice at most large hospitals across the country. Insurance doesn't care because they don't pay.
                          Hospitals profit so they are willing to take a little bad publicity. I think kamban has it right.

                          Yes I agree it's a terrible thing but from my perspective it's fighting a losing battle. Someday Medicare will disallow it and facility fees will go away. Until then we pay. Jmo.

                          Comment


                          • #28
                            I do not plan to resign.  When I cease to work it will be called retirement.  I really do not think my hospital has been doing this for very long.  I have not heard any complaints before and neither have any of my friends. My hospital is the third largest publicly owned hospital system in the country with 1800 beds and 12000 employees.  I use the original and largest hospital in the system.

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                            • #29
                              when we started it created some anger in the community for a year.  after that it was forgotten and accepted.  i'm sure the administration is expecting some flak and expects that it will resolve with some time.

                               

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                              • #30
                                This is why our patients think we make as much money as the star running back on the local NFL team. They see these ridiculously high charges, and assume that we profit off of it.  And they hate us for it.  We are lumped in the same category as that jerk of a drug company CEO who jacked up the price of his antibiotic used in HIV related fungal infections from $7 to $750 a pill. These kinds of things make our daily interactions more difficult and severely degrades the doctor-patient relationship.

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