Facility Fees: Understanding The Hidden Charges

Did you know that where you see your doctor can affect the charges you pay for your visit?

We live in a time where health care costs are through the roof due to higher deductibles and co-pays. With the increase in health care costs, patients are trying to get a better understanding of their medical bills.

We have all been there, you go to your doctor for what seems to be a routine visit.  You get home and a few weeks later you get a bill in the mail. You have an idea of what you owe, until you open your bill. Bam, then it hits you, the bill is for three times what you thought it would be. This happens far too often to patients.

When you read through your bill you will see a list of services provided and their associated costs.  That is pretty normal, however, in some instances, you will find fees that some doctor’s pass along to their patients.  For example, depending on where you see your doctor, you may be asked to pay a facility fee.  This is becoming a more common practice in the medical industry.

What are Facility Fees?

 A facility fee is a charge associated with seeing a doctor at a clinic not owned by the doctor.  This is very common with doctors who work at clinics that are owned by hospitals to cover the overhead costs of running the clinic.  Patients are being charged facility fees in the upwards of hundreds of dollars, depending on the services received.

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Are Facility Fees Covered by Insurance?

 Most insurance policies do not cover facility fees, leaving the patient to cover the fees in full and out of pocket.  In rare instances, some insurance policies will cover a portion of the fee or have a separate deductible for fees of that nature.  It is up to you to understand your policy or get a hold of your provider if you are unsure as to how your insurance handles these fees.

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What can you do to avoid them?

In short, DO YOUR RESEARCH.  It is much easier to understand and address these fees before you see your doctor instead of after you have received your bill.  Here are a few suggestions to follow when trying to avoid facility fees:

  • Look at your previous medical bills. In most cases, patients get their bill and blindly pay the balance. Look at your bill to see what you are paying for. If you have questions contact the clinic.
  • When making an appointment with a clinic, ask if you will be charged a facility fee.
  • If the clinic charges a facility fee and you do not want to pay it, ask if the doctor sees patients at a different location that does not charge a facility fee.
  • Find a privately owned clinic. Privately owned clinics assume the daily overhead costs of operating the clinic instead of passing those costs along to their patients.
  • If you have chosen to see a doctor at a clinic that charges facility fees, educate yourself as to how this particular clinic charges those fees. In some instances, the clinic will charge a flat rate and in others, they will charge a percentage based on the services you received.

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