On Your Side: What to know before your next doctor’s visit
SPRINGFIELD, Mo. (KY3) - Mercy patients could be facing a new fee if they visit certain clinics.
Many got a letter in the mail recently saying you might see a “facility fee”. On Your Side has covered facility fees for years.
It’s a health care billing practice that’s becoming common across the country, in states where it’s legal.
David Anglin is losing his sight. Monthly injections help.
“I get an injection in my eyes that’s supposed to slow the process down,” said Anglin.
Until recently, he had a $30 co-pay. But after his last appointment, he got a bill that shows he owes $262.55
“Mercy told me it was a facility fee,” he said.
Mercy confirms to On Your Side that three clinics, headache, urology, and ophthalmology, started billing patients what’s known as a facility fee.
Plus, Mercy Imaging Services in Smith, Glynn, and Callaway in the south recently became a provider-based department. That’s also known as an outpatient hospital-based department. This means patients get two separate bills. One from the physician and one from the facility, even if it’s a short visit.
The letter says patients ‘may pay more out of pocket’, but doesn’t say how much.
A facility fee is a separate charge that On Your Side has talked about in past reports. Some CoxHealth and Citizens Memorial Hospital clinics have facility fees, too.
These clinics are held to the same standards as hospitals. Which the health systems say are more costly than traditional clinics.
“I think facility fees are an expensive financial gotcha for consumers,” said Chuck Bell, Financial Policy Advocate for Consumer Reports.
“We are already paying the provider to deliver the services, so if you give them this ability to charge for overhead, it will be a lot of money for patients,” said Bell.
“I don’t think it’s the patient’s responsibility to take care of the maintenance on the building and to pay the staff,” said Anglin.
“If you call the facility in advance they might be able to tell you what the facility fee would be for the particular service that you’re getting, but most of the time it comes as a rude surprise to the consumer and that’s why it’s really unpopular,” said Bell.
Mercy Hospital leaders declined our request for an on-camera interview, but said in a statement:
Patients should never get a surprise bill, which is why we take several steps to make sure they’re informed of the care they’re scheduled to receive. Along with signage at our hospital outpatient departments, patients are provided with a good faith estimate of the cost of their care when they check in.
Some states are making it illegal for clinics to charge the fees.
“More than twenty states have passed laws that laws that restrict the amount facility fees and the settings of which they can be charged and that might be something Missouri should be looking into as well,” said Bell.
Neither Missouri nor Arkansas has facility fee laws on the books.
Here’s what you need to do before you go to the doctor.
- Be sure to call your insurance company before your appointment and ask if they’ll help cover a facility fee.
- All hospitals should be giving you an up-front estimate.
- For Mercy - See if there’s a cost estimate on the MyMercy site.
- When you get to the clinic, look for signs in the lobby and ask plenty of questions.
Bottom line: if you go to one of these clinics, you’ll need to budget for two bills.
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