facebook Same doctor, same treatment— but her bill was 10 times higher

BIG PHARMA POLITICS: Consumers pressure politicians to do something about rising drug prices. Read More

Same doctor, same treatment—
but her bill was 10 times higher

Medical bill and insurance form with calculator & stethoscope

A billing change sent one woman’s hospital bill soaring—from $30 to $1,394, according to KHN.

Kyunghee Lee runs a dry-cleaning store and has been treated for years by an Ohio rheumatologist. The typical cost for a pain-relieving steroid injection for her arthritis has been about $30, and the steroids seem to help.

This past summer, Lee donned a mask and went in for her usual shot. She saw the same doctor in the same building but noticed the office had moved up a floor. That move proved to be expensive. The hospital tacked on a $1,262 facility fee, as well as a clinic charge and a pharmacy charge. After insurance, Lee owed $354.68.

Why the extra fee? The hospital system moved from what it says was an “office-based practice” to a “hospital-based setting.” The so-called “facility fee” is essentially a room-rental fee—and it comes without warning.

“Facility fees are designed by hospitals, in particular, to grab more revenue from the weakest party in health care: namely, the individual patient,” Alan Sager, a professor of health policy and management at the Boston University School of Public Health, told KHN.

States including New York, Oregon and Massachusetts are working on legislation to cut back on this practice. But it’s not an easy battle.

As for Lee, she called her doctor’s office to complain and ended up being sent to the billing department. There was no resolution. After a threat to send her to collections, Lee and her family gave up and her daughter paid the bill.

You might wonder how you can make sure this doesn’t happen to you? Call your physician and ask if your outpatient procedure will happen in a place considered a “hospital setting” and ask outright if there will be a facility fee.

Has this happened to you? Share your comments and experiences here.