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A new twist in healthcare billing: the 'facility fee'

That will be $75, or more, for just walking through the door.

December 21, 2009|By Emily Dwass

Possibly coming soon to a doctor's office near you: a little something extra on your bill, not covered by insurance -- a nifty number known as a "facility fee." What is it exactly? Here's a fun experiment: Ask five medical professionals. Most likely, you will get a variety of explanations, all guaranteed to make you respond, "Huh?"

"Healthcare billing is complex enough without throwing another factor into the mix," writes the website FierceHealthFinance. "Increasingly, however, it seems that consumers are being caught off guard by a new bill -- a 'facility fee' for visiting doctors based in a hospital-owned building -- which these days they're usually expected to pay on their own."

I definitely was caught off guard when I checked in to see a specialist in a Cedars-Sinai Medical Center building in Los Angeles and was told to pay a $75 facility fee. When I asked what that meant, the receptionist explained that this was a fee being levied to cover the wear-and-tear I would inflict on the office.

Or at least I think that's what he said. Though I already was somewhat dazed by my medical problem, I did grasp that the extra charge was being imposed simply because I was in the house.

What if I promised not to touch anything? Could the fee be waived? I didn't even need to sit down. I could stand in the corner, on my newspaper.

No dice.

So I handed over my credit card, then went into the ladies' room. I entered a stall and discovered -- no toilet paper! Excuse me, but if you're going to charge patients a facility fee, then how about maintaining the facilities?

My next encounter with a facility fee took place when I called UCLA to make an appointment for a routine check-up with a new doctor. The appointment secretary said this doctor had offices at the UCLA buildings in Westwood and Santa Monica. Which did I prefer?

Westwood, please, I said. In that case, she replied, she needed to inform me that there would be a facility fee of $150 to $300, which would not be covered by my insurance.

How about the doctor's office in Santa Monica? Would there be a facility fee there? Nope.

Gee, let me ponder this for a while. Hmmm . . . I'm thinking . . . make the appointment in Santa Monica.

Why, I wondered, would the fee range from $150 to $300? Based on what? Perhaps the patient's weight -- the logic being the heavier you are, the more damage you'll inflict on the carpet? Well, I just lost 5 pounds, so how about a discount?

What if I tiptoe? Bring a little broom with me and sweep up after myself? Carry some cleaning spray and erase any marks I make?

A few days later I received written confirmation of my appointment. This included a warning, in screaming caps: "MAKE SURE ALL FOLLOW-UP CARE IS IN THE SANTA MONICA OFFICE," rather than Westwood, to avoid a facility fee.

Isn't this a tad passive-aggressive? "We have an office for your convenience in Westwood, but don't even think about visiting it!"

It's not hard to imagine how expensive it is to run a medical office these days. I get that. But what I don't get is why patients are being asked to pay extra when we seek care in a particular building.

Frankly, I wouldn't resent so much paying an "outstanding doctor fee" or a "help pay off the medical school loan fee." But a "facility fee"? That just seems wrong.

Dwass is a freelance writer in Los Angeles.

My Turn is a forum for readers to recount an experience related to health or fitness. Submissions should be no more than 500 words. They are subject to editing and condensation and become the property of The Times. Please e-mail We read every essay but can't respond to every writer.

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