[Music] DAN: With all the
changes in health care you might be seeing your
doctor in a new location and with that might
come a hidden fee. It’s called a facility fee
and today I’m here with Shara McClure, who’s our
Senior Vice President for Health Care
Delivery at Blue Cross. So, Shara what’s
a facility fee? SHARA: So, a facility
fee is a price that a hospital charges
to access services. So if you separate the
way a hospital bills, from the way
a physician bills, physician bills for the
services that are provided in their offices, but if that
physician is affiliated with a facility you could see
a bill for both services. DAN: But I’m not going
in the hospital, right? I’m just seeing my doctor
I’ve seen my doctor the same doctor for a
long time and now I’m asked or I get my
bill and I have a $600 facility fee. Why
did that happen? SHARA: It happened because
that physician is affiliated with the hospital and
that hospital feels like they’re providing outpatient
services but in reality it’s just as
you describe. That physician, one
day can be independent and not have a facility fee
and then all of a sudden they’re acquired by a
hospital and boom you get the facility fee
as well as the physician. DAN: So, I think we need
to be pretty clear here, so my doctor is probably
not getting that facility fee, it’s not necessarily
going to my doctor right? It’s just something that’s
getting added because he now works for a
hospital system? SHARA: I think so, now
I’m not privy to what the doctor gets but again it just
immediately changes and I guess that office all of
a sudden becomes like an outpatient facility
of a hospital and… DAN: So it’s almost like I
was going to the emergency room when I get charged
that facility fee? SHARA: It kind of is because,
you’re right you go into the emergency room you get
treated by a physician you use the hospital services
maybe their observation room, or their exam room, or
their MRI, or their lab but you get charge for both
the hospital bills and the physician bills and I
guess you can think of this as a
smaller scale. DAN: So, I think every
consumer in America right now is used to the added
fee it seems like every time I open my utility bill
I’ve got a new surcharge new fee, new tax so that
in and of itself is not shocking but what shocked
me about the facility fee was this is not a little fee.
This was like $600! SHARA: It can exceed
the services that just the physician provides, or just
the services that the physician would have
provided had they not been part of a
hospital system. DAN: Okay so I’m just
gonna be frank with you. This seems wasteful to
me because the same service that I was getting with
my physician before I’m getting the same service
now and now I just have a cost added
to it? SHARA: We hear about
that a lot from patients. We hear about it from
employers, how it feels like just overnight the price
has escalated without the corresponding increase
in service or increase in quality. DAN: So Shara what
can I do… what can a consumer, member
do if they get an explanation of benefits
and it’s got a facility fee? Can they contest that or
do anything about that? SHARA: I think that they
should let their physician know that they’re
not pleased with it. They can make a complaint
to the facility that’s charging the service and as an
alternative they can look for other physicians that
practice independently and don’t charge a
facility fee. DAN: Great. Well, thanks
for shedding a little light on the facility fee and thanks
for joining us for this episode of
Blue Promise. [Music]