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Hello, First I hope you are feeling beettr each day! I know from experience how tough treatment can be and I hope your spirits remain high.I came across your site while doing some research on facility fees . I've worked in healthcare for 25+ years and your explanation and advice on the subject was excellant. I know how hard it is to go throught treatment and the added stress of figuring out bills is crazy. I'm also glad that you were ultimately able to have these adjusted off your bill. I have some add'l information from my research I thought I'd share, I hope you don't mind.Facility fees were meant to cover the additional overhead costs incurred by hospitals when they provide care in a “provider based†(i.e. hospital) setting. Although it is legal to charge these facility fees based on current Medicare regulations which define a “Provider based†setting, ultimately in many cases the patient is burdened with paying the fees until their deductible is met. In some cases the fees are appropriate but I agree that for physician office visits they are not. Many hospitals across the country charge these fees for their employed physicians when they meet provider based status (they put a sign on the door saying you are now entering ABC Hospital!). There are still a few (including mine) who do not charge these fees even though they could because they realize they are not really incurring any additional costs than a freestanding practice and it is not ethical to charge their patients just because the Medicare systems has a flaw currently allowing this practice. MedPac (Medicare Payment Advisory Commission) has been anticipating an increase in employment of physicians and thus more services being billed as facility based and is recommending that Medicare begin paying the same rates for the same service across different setting. MedPac’s Report to the Congress, March 2012, stated: “The potential effect on Medicare spending of a large shift in these visits from freestanding physician practices to hospital-based clinics that are billing as part of an OPD (outpatient department) is significant. If the percentage of E&M office visits that are provided in OPDs grows at 12.9 percent (as it did in 2010) over 10 years, about 24.5 percent of E&M office visits will occur in OPDs in 2020. Such a shift would increase program spending by $2.0 billion per year and beneficiary cost sharing by $500 million per year (assuming 2010 payment rates).â€MedPac has proposed:“The Congress should direct the Secretary of Health and Human Services to reduce payment rates for evaluation and management office visits provided in hospital outpatient departments so that total payment rates for these visits are the same whether the service is provided in an outpatient department or a physician office. These changes should be phased in over three years.â€Unfortunately CMS(Medicare) did not include this recommendation into their proposed rule for 2013. I think they'll have to find another way to eliminate this practice.
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(VISITOR) AUTHOR'S NAME
Erkan
MESSAGE TIMESTAMP
19 december 2014, 05:54:09
AUTHOR'S IP LOGGED
107.191.96.123
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