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Sickofbaltimore t1_j9d1gzl wrote

Reply to comment by Xanny in Hospital fee to see a dermatologist at John's Hopkins Outpatient facility? by HombreDeCamote

No.

The facility fee is required to be a separate line item for outpatient hospital-based visits. So people notice it. You are still paying it for other outpatient visits but the charge items are together so you might not see it listed.

Edit: every hospital has this information on their website if you search for the facility fee.

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upsidedownbat t1_j9df2wv wrote

I don't think that's true. My dermatologist is at Mercy downtown and they have signage all over their office that warns of the facility fees and suggests that you visit their other office in Lutherville or Overlea if you want to avoid fees.

My insurance now pays for the fee (Carefirst) but years ago when I had a plan through Evergreen it did not pay for it.

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Sickofbaltimore t1_j9difzo wrote

This is just where insurance muddles things and creates confusion.

It's explained on Mercy's website in the FAQ for facilities fees.

https://mdmercy.com/patients-and-visitors/billing-and-insurance/hospital-charge-and-facility-fee-information

>A hospital facility fee is separate from and charged in addition to the fee billed by your doctor for the professional services provided during the visit. In a non-hospital setting, these fees are billed together.

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Xanny t1_j9fdgj0 wrote

So I have BCBS Illinois and in their general regulations they have this statement: https://i.imgur.com/6ftpHcP.png

I'm seeing a doc at JH next month so it will be interesting to see how that plays out. They are in network with BCBS Illinois so they should be bound to this provider contract stating no facility fees.

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Sickofbaltimore t1_j9fe4rn wrote

That will be interesting!

The facility fee as a separate line item is Maryland law.

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HombreDeCamote OP t1_j9scr5k wrote

Do you know why this law is in place?

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Sickofbaltimore t1_j9vstpt wrote

Well, it's sort of a long story so I'll leave a lot out but if you want to know more, you can Google " HSCRC and Facility Fee"

Maryland is special when it comes to rates charged by hospitals. I believe it's the only state that has their own Cost Review Commission (HSCRC). The HSCRC is a state agency that basically sets cost ranges for healthcare services. They actually set the rates hospitals can charge for the facility fees.

Anyway, two of the goals of the HSCRC is price transparency and lowering costs (and they do a pretty good job). The bill basically says hospitals can charge the facility fee, but it needs to be transparent (they have to tell you about it) and the bill also says the patient can request a written estimate of charges at any time before or during their visit.

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