Facility Fees an Unpleasant — and Costly — Surprise | submitted by Cheryl DeMars

A “surprise” fee is never a good thing. When it comes after a medical appointment, it’s especially confusing. Yet today, more and more consumers are being charged “facility fees” and finding out about it only when the bill comes.

Facility fees are charged, in addition to the full price for an office visit, when the clinician providing the service does not own the building in which care is delivered. Alliance analysis indicates that facility fees add an average of 78.7 percent to the total billed charge for an office visit. Combined, our member employers paid more than $1.7 million in office visit facility fees in 2008.

Consumers are often not aware that these fees are incurred until weeks after an appointment when they receive their bills. By this time it is too late to make decisions about where to receive care or to budget for the fee, which can range from $25 to hundreds of dollars.

Letting consumers know in advance that they will have to pay a facility fee could help them save money by choosing care in another location. Doing so is sometimes as easy as seeing the same physician at a different location, where a facility fee is not charged.

State of Wisconsin Assembly Bill 207 would address this issue by requiring providers who charge a facility fee to let consumers know about this fee at the time an appointment is made and to provide a good faith estimate in advance. It is a common-sense baby-step toward improved “transparency” in health care.

As an employer-owned and directed not-for-profit health care purchasing cooperative, Alliance members are committed to moving health care forward by controlling costs, improving quality and engaging individuals in their health. Support of AB207 is a natural step for employers like us who are working to help their employees become more informed consumers of health care. We encourage others in the business community to contact their elected officials to urge passage of AB207 this session. To find your legislators visit www.legis.state.wi.us/w3asp/waml/waml.aspx.

Cheryl DeMars is the

President and CEO of The Alliance.

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