‘Surprise’ Fees from Your Doctor
In recent years, a new trend has appeared on medical bills. The pattern is this: After more than 20 years with the same doctor, you’re shocked to get a bill exceeding $2,000 for a routine check-up. These ‘surprise’ charges are now common in many U.S. states as hospitals acquire private practices and add extra hospital fees with little or no notice until you show up for your appointment.
CBS News reports that these surprise fees can range from $25 to thousands of dollars for routine office visits, telehealth, or outpatient services. When a doctor’s office is purchased by a hospital system, additional fees are added to cover hospital overhead such as security and utilities. However, these fees are increasingly being charged in non-hospital settings as well.
Even if you’ve seen the same doctor for years, once a hospital acquires the practice, billing may include facility fees. Insurance usually doesn’t cover these, or they count toward high deductibles, leaving you responsible for the cost.
Laws restrict ‘surprise’ fees by requiring hospitals to notify patients in advance, but you may already be at your physician’s office before getting this notice. Added fees are generally not covered by the federal No Surprises Act, which covers emergency services like air ambulances and non-emergency care at out-of-network facilities.
This trend often leads patients to skip checkups or go into debt to cover costs not paid by insurance.
So, how do you know if you will receive a surprise facility fee?
Call before you go.
- Talk to your doctor’s office before your appointment and ask if the practice is considered a “hospital outpatient department” and if a facility fee applies, even if you have seen the doctor for many years.
- Ask for a good-faith estimate of any fees before you go.
If you have been charged a fee, what do you do?
Ask for an itemized bill.
- Call the billing office to discuss unexpected charges, often listed as “clinic fees” or “room charges.”
Negotiate.
- Some offices provide payment plans or cash discounts if you choose not to use your insurance.
- Private practices not affiliated with hospitals can be difficult to locate in some states. Research your options locally and learn the facts before visiting a new doctor to avoid surprise charges.
Don’t let surprise fees catch you off guard. Call Insurance Group of the Ozarks today at 417-725-1131 or visit https://www.igotozarks.com for expert advice on insurance options in Missouri. Source: NBC News, “Did your doctor’s office charge you a ‘facility fee?’ Here’s what to know.”
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