6 things to know about facility fees

More than ever before, patients want to know the charges associated with their care, as they take on a greater share of their healthcare costs with higher deductibles and co-pays.

One expense patients are becoming more aware of is a facility fee, according to a Daily Item report.

Here are six things to know about facility fees.

1. Facility fees allow a healthcare organization to bill patients a service charge for the patient's use of hospital facilities and equipment. In some cases, a patient may be responsible for the service bill if their insurance declines to pay or if the patient has a high deductible health plan. Hospitals can charge patients facility fees if they see physicians who work in an office that is owned by the hospital.

2. Ultimately, the fees help offset costs to operate hospitals and outpatient clinics, along with access to support staff and physicians, according to the report.

3. Hospitals charge facility fees for outpatient services performed by employed physicians that independent physicians do not charge. Facility fees can increase the total cost of a service by three to five times compared to the same service provided by an independent physician, according to an Orlando Sentinel report, which cites information from the Medicare Payment Advisory Committee.

4. Facility fees have been a hot legal topic and remain controversial. Consumers have increasingly complained about unexpected provider-based billing, which allows a healthcare organization to bill patients for physician care in addition to a service charge for the patient's use of hospital facilities and equipment. The practice has spurred federal regulators to examine the procedures in place for hospital service charges and pricing transparency, reports The Plain Dealer. Federal regulators, concerned with rising care costs and consumer complaints, plan to review the impacts of provider-based billing this year.

5. Additionally, a new law in Connecticut, which went into effect Jan. 1, requires all hospitals and health systems that acquire a physician group and plan to implement a facility fee to notify the practice's patients from the previous three years.

6. And last year, President Barack Obama signed legislation outlawing provider-based billing at off-campus outpatient facilities, however the law does not apply to existing outpatient centers.


More articles on finance and revenue cycle management:

Physicians who receive lots of pharma cash prescribe more brand-name drugs, study finds
Presence CEO says poor collections to blame for $186M operating loss
House Republicans unveil 2017 budget: 7 things for healthcare leaders to know


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