Providers devise new fees to levy against patients
Challenged by insurers ratcheting down their payments, hospitals and medical groups are creating more fees and charges for patients to pay as part of the care they receive, The New York Times reported.
For example, providers are getting patients to agree to pay for slings if their insurer will not cover the item. They also may charge an "activation fee" for the use of trauma and other medical teams or fees for services that had previously been provided without specific charges, such as placing a limb in a splint, inserting an intrauterine device, blood work for healthcare reform-mandated free physical examination, or charges for a room if a patient is receiving services that require privacy.
"If a provider chooses to do something beyond what's covered, there may be charges," Clare Krusing, a spokesperson for America's Health Insurance Plans, told The New York Times.
Patients are increasingly receiving such charges because physicians and other providers can bill at their discretion, and they "may be forced to charge" for these services because the Affordable Care Act has shifted "so much responsibility for payment from insurers to patients," Cindy Weston of the American Medical Billing Association told The New York Times.
However, the practice has stirred concern among healthcare advocates, who note that patients may avoid needed healthcare services due to the potential of being nickel-and-dimed by their providers. And unlike those covered by Medicare, patients with commercial insurance are not required to be notified in advance by their provider as to what services they do not believe their carrier will cover.
These charges are on top of facility fees--charges levied by hospitals and medical groups for accessing their campuses for services--which have led to significant consumer pushback against providers such as Tenet Healthcare Corporation and the Cleveland Clinic when they began charging them several years ago.
To learn more:
- read the New York Times article
Patients sue Tenet Healthcare for hidden facility fees
Balance-billing compromise: Disclose out-of-pocket costs
Be upfront with patients about facility fees
CA sues Prime Healthcare for balance-billing insured patients
'Facilities fees' for doctor visits startle patients